Why is RFK Jr. Pushing US Organ Procurement System Reform?

Robert F. Kennedy Jr., United States Secretary of Health and Human Services (HHS), is seeking to overhaul the nation’s organ transplant system.

His reform plan follows declining public trust, fewer organ donor registrations and a federal investigation highlighting patient safety failures.

At the centre of this initiative is the potential decertification of an organ procurement organisation in Florida, a move that could reshape how organs are donated and transplanted across the country.

Kennedy explains that the system needs to change to protect patients and restore confidence.

"Every American should feel safe becoming an organ donor and giving the gift of life, yet decades of ignored patient safety concerns have driven more and more Americans off the donor list," said Robert. 

"Today, under President Trump's leadership, we are taking bold action and historic action to restore trust in the organ procurement process."

Decertification and patient safety concerns

There are 55 organ procurement organisations in the US. These are non-profit agencies responsible for recovering organs and tissues for research and transplant.

They are federally certified and regulated by HHS. One of these is the Life Alliance Organ Recovery Agency, part of the University of Miami Health System.

The HHS Secretary has moved to decertify Life Alliance, citing procedural lapses and safety concerns.

Decertification would effectively close the agency and act as a warning to other organisations. He argues that reform is overdue and necessary to safeguard donor and patient confidence.

According to HHS, an investigation into organ procurement found multiple cases where patients may not have been eligible for donation or where recovery procedures were mishandled.

This included 351 instances where donation was authorised but not carried out, with 30% of cases linked to neurological signs that made donation unsuitable.

Investigators reported that at least 28 patients "may not have been deceased at the time organ procurement was initiated".

In a letter to the centre, House Ways and Means Committee Chairman Jason Smith and House Oversight Subcommittee Chairman David Schweikert wrote: "Patient safety lapses have long been a recurring issue for your organisation and others like it, reflecting a history of ongoing concerns rather than isolated incidents."

The Association of Organ Procurement Organisations, of which the centre is a member, states: "We and our members will keep saving lives nationwide" and "will continue to support the team at Life Alliance to ensure South Florida organ donors, transplant patients and their families have access to organ donation and transplantation services.

"As advocates for the patients and donor families we serve, OPOs are committed to and invested in the ongoing improvement of our nation's organ donation and transplantation system. Patient safety is the top priority for everyone involved in this life-saving work and it guides our actions every day."

Declining donor registrations

Public trust in organ donation has declined after a series of high-profile cases.

In 2021, a man in Kentucky was mistakenly declared dead and was nearly subjected to organ removal before doctors intervened. Media coverage of this case raised widespread alarm.

Within a week, an average of 170 people per day removed themselves from the donor register, ten times the number seen in the same week in 2023.

Although the man survived, the incident has had long-lasting effects on public confidence.

Reports of similar cases have surfaced, further fuelling hesitancy to register as donors. This trend poses a serious challenge to the transplant system. With thousands of patients waiting for life-saving organs, the decline in available donors could result in preventable deaths.

The HHS Secretary acknowledges this risk and highlights the urgency of reform: "We are acting because of years of documented patient safety data failures and repeated violations of federal requirements, and we intend this decision to serve as a clear warning."

Reforming the procurement network

Beyond decertification of specific organisations, the Secretary is pushing for wider reforms to the Organ Procurement and Transplantation Network.

This national system coordinates the allocation of donated organs. He aims to make the process more accountable, transparent and appealing to potential donors.

The reforms come at a time when trust in healthcare systems is under pressure.

By focusing on safety and reliability, he hopes to restore faith in the process and encourage more citizens to remain on or join the organ donor register.

The outcome of these changes could redefine organ procurement in the US.