Which Master Does UNOS (and OPTN) Serve?

Yes, I am an info junkie. Fortunately, I have friends who are also info junkies so we swap links and articles (believe me, this is a much better ‘ring’ than some out there on the ‘net).

Recently I was sent “Please UNOS, Transplantation is a Fragile Public Trust” by Dr. George W. Rutecki. He highlights UNOS ‘lack of oversight’ as stipulated in a 2007 GAO report, meaning that despite bad behavior on the part of transplant centers, UNOS doesn’t do a damned thing about it (Please read the article for the overview of people dieing and otherwise).

Near the end, he makes this statement:

They are not able to be police because they represent the transplant community, not patients.

While this might fly counter to common sense, it’s absolutely true. OPTN was originally created to deal with the procurement and allocation of deceased organs. In other words, their job was to administer the national waiting list and ensure that donor organs were distributed equally. As years have worn on, these duties have expanded, and the line between UNOS and OPTN has blurred considerably. OPTN is a membership organization reporting to Dept of Health; UNOS is a private contractor hired by OPTN. Mr. Rutecki engages in this confusion himself by referring to the OPTN-UNOS unit solely as UNOS.

However, the point remains the same. OPTN is comprised of ‘members‘, theoretically representing all aspects of the transplant community.

Let’s break it down:

– 250 transplant centers (who generate huge revenue for each transplant they perform)
– 58 Organ procurement organizations (the folks who deal with deceased donor organs)
– 154 laboratories (because they make big bucks on tissue typing all those organs and would-be recipients)

And on a generous note, the ‘members’ that could possibly be a bit more neutral or patient-guided:

– 21 medical scientific organizations (they don’t reveal whom, and considering OPTN is an arm of a public policy organization, I’m wondering if they can legally conceal that information, but I digress. I also wonder if any of them are pharmaceutically connected, especially in the realm of anti-rejection meds)
– 2 business members (same as above)
– 9 individual members (same as above)
– 10 public organizations

By sheer numbers, the interests of UNOS and OPTN are heavily weighted in favor of the transplant centers and those orgs that benefit from MORE surgeries. However, this dispartity worsens when one peruses the list of ‘public organizations’.

Every single one of them are recipient-related. They all have the goal of increasing the number of donor organs available so more transplants can be performed and more ‘sick’ recipients potentially healed.

There is not a single voice out there for living donors or the unwitting and well-meaning public constantly targeted to be future living donors.

So who are UNOS and OPTN serving by NEVER shuttering a single transplant center, regardless of their destructive behavior? And exactly whose interests are they furthering when they concoct Paired Kidney Donor Pilot Projects that have NO safeguards for the living donors?

Not me. And certainly not the tax-paying public to whom they owe their existence.

Add Your Thoughts