The Department of Health and Human Services recently announced that it plans reforms to the nation's organ transplant system.
The announcement comes after an investigation by the Health Resources and Services Administration uncovered questionable practices at a federally funded organ procurement organization (OPO).
The Kentucky Organ Donor Affiliates (KYDA), recently merged with and rebranded as Network For Hope, is one of 55 federally funded organ procurement organizations. At the time disputed practices took place, the KYDA operated in Kentucky, southwest Ohio, and parts of West Virginia.
Under HHS Secretary Robert F. Kennedy Jr., the Health Resources and Services Administration (HRSA) began reviewing the OPO system after reports raised concerns about the unethical treatment of vulnerable patients.
The HRSA assessed data from 351 KYDA cases from 2020 to 2024 and found that 29.3% showed signs of concerning OPO practices. According to the agency, "At least 28 (8.0%) patients had no cardiac time of death (CTOD) noted" when organ procurement was initiated.
One of those 28 patients, KYDA-001, was subject to extreme negligence. KYDA-001 was a registered organ donor, and his next of kin consented to donation after circulatory death (DCD). Protocols require hospital staff to monitor a patient's vitality until the breathing tube is removed, and the procurement procedure begins.
In KYDA-001's case, the OPO and hospital failed "to reassess the decision to pursue organ recovery" even though staff documented "improving neurologic function."
The HRSA noted that "At multiple points, KYDA staff recognized the patient as having a high and increasing level of neurologic function, but did not deviate from plans for DCD organ recovery."
The OPO's electronic medical record obtained by the HRSA showed after the patient was wheeled into the operating room and was awaiting surgery, he began "'shaking his head no and tears were rolling down his face.'"
The report then stated hospital staff were uncomfortable continuing the procedure after the patient showed clear signs of life. Their concerns led to the cancellation of the procedure, and the patient was returned to the ICU. He was later discharged alive, according to the HRSA.
The Department of Health and Human Services underscored its commitment to "restoring integrity and transparency to organ procurement and transplant policy" through instituting reforms aimed at protecting "the rights and dignity of prospective donors and their families."
According to the HHS press release, if the reforms are not adopted by the Organ Procurement and Transplantation Network, Secretary Kennedy will decertify the OPO.
(Alannah Peters is a rising senior at the University of Florida and a summer intern for John Gizzi.)
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