American organ collection system questioned. A monopoly follows its own criterion

The shortage of organs for transplants is a matter of medical concern with obvious bioethical implications. The first question is if this shortage could be reduced by improving the organ collection system. The issue appears to be a top priority, given that 107,000 patients are on waiting lists for organs and 33 people die each day while waiting for a transplant in the United States (US) alone. This situation is one of the reasons for the increase in human trafficking (read HERE), read also our report An estimation of 10% of worldwide transplants are commercialized but it is impossible to know just how large the trade may be. In this respect, the US administration has a particular organization to collect organs through Organ Procurement Organizations (OPO), each of which has an assigned area; these monopolize all organ collection in the country.

organ collection system questioned

American organ collection system questioned: low efficiency and lack of transparency

A Washington Post report published May 5 (read HERE), says “Some OPOs perform quite well, but others have failed for years to secure even a fraction of the available organs in their regions. Partly as a result of their inefficiency […]”.

A debate about the efficiency of OPOs led the Trump administration to create a commission to evaluate these institutions. Matthew Wadsworth, the chief executive of Life Connection Ohio, told the commission that “The OPO industry is broken, which is to say all too often it does not serve patients.” He described organizations that face no consequences ‘for letting patients die’ even as they reap huge financial gains.”


He described OPO organizations that face no consequences “for letting patients die” even as they reap huge financial gains.”


The Biden administration has deferred the application of the measures suggested by the aforementioned lawmaker’s commission until 2023. Many organizations have disagreed with this decision.

The WP reports that the chairman of the aforementioned commission, Raja Krishnamoorthi, “cited an April 5 story published by the Project on Government Oversight in which anonymous sources within the OPO industry were quoted as saying about the congressman: ‘We need to share only the minimum information required, and he’ll eventually go away.’”

The article continues, “An obviously irritated Krishnamoorthi ended the hearing by telling the AOPO (Association of OPO) representatives: ‘I’m not going away, and we are not going away. The issues here are about life and death. And because of that, you can expect more and more inquiries from us the more you obstruct our investigation.’”

Bioethical statement

From a bioethical perspective, it is difficult to understand the lack of government oversight of such a sensitive task in the hands of a monopoly, much less the absence of transparency of some OPOs, which affects the credibility of the current system of organ transplant. And even more difficult to understand the current Administration delaying 2 years to correct the aforementioned serious fails.