President Joe Biden and his administration announced a overhaul of America’s national organ transplant system Wednesday.

The overhaul includes strategies to modernize the system to “shorten wait times, address racial inequities and reduce the number of patients who die while waiting,” The New York Times reported.

According to the Times, more than 100,000 people are waiting for organ transplants in the U.S. — some patients can even wait years to be considered.

“That is why we are taking action to both bring greater transparency to the system and to reform and modernize the OPTN. The individuals and families that depend on this lifesaving work deserve no less,” Carol Johnson, U.S. Department of Health and Human Services’ Health Resources and Services Administration administrator, said in a statement.

How does America’s organ transplant system work now?

Since 1986, the United Network for Organ Sharing, a U.S. nonprofit, has been charged with running the organ donation system, under contract with the federal government. “It oversees 56 Organ Procurement Organizations, which are responsible for recovering organs for transplant,” ABC News reported.

The Senate Finance Committee reported on the Organ Procurement and Transplantation Network in 2022 and called the information technology system “outdated, mismanaged and insecure,” according to CNN.

Another issue that the network dealt with was with logistics and getting the organs to the people who need them fast enough. According to Dr. Jayme Locke, “1 in 4 kidneys are actually discarded in the United States, are not transplanted,” she told PBS. “That’s 1 in 4. That’s 25%. And those are really lives that could have been saved if we could have utilized those organs.”

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Racial and regional inequities are also a problem with the current system. The National Library of Medicine reported that Black people are four times more likely than white people to experience kidney failure. Latin people are one and a half times more likely to have kidney failure compared to white people. However, individuals in those demographics are less likely to even get on the waitlists for transplants.

Why? To get on the waitlist to receive an organ transplant, primary care and specialty clinicians must first evaluate the patient and determine if they are a good candidate to receive an organ donation.

Things that prevent being put on the waitlist include “being older, having lower income, public insurance, more comorbidities, or being on dialysis at the time of kidney transplant evaluation,” according to a report done by the National Academies of Sciences, Engineering and Medicine committee.

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How will the U.S. organ transplant system be overhauled?

Biden’s administration “is breaking up the monopoly” that the United Network for Organ Sharing has held over the system. It will open up more competition for bidding and push for immediate upgrades to technology that matches donors to recipients, Axios reported.

More competition means more innovation.

The plan increases funding for organ procurement and transplantation to $67 million, per CNN.

The Health Resources and Services Administration within the U.S. Department of Health and Human Services, launched a dashboard available online to share information surrounding organ donors and transplant waitlists, per ABC News.

 ”The announcement to break up the national organ monopoly is a huge win for patients,” Jennifer Erickson, a senior fellow at the Federation of American Scientists, told Axios.

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