Modernization Updates

Building Trust Through Action: Advancing Oversight, Policy, and System Modernization

December 2025 Update 

HRSA and the Organ Procurement and Transplantation Network (OPTN) are driving forward a comprehensive modernization effort that is already translating plans into measurable improvements. Together, they are strengthening oversight, enhancing patient safety, and increasing transparency across the national procurement and transplant system. This work reflects a shared commitment to collaboration and accountability, ensuring continuity of care while building long-term system resilience. Through aligned policy reforms, operational upgrades, and technology-driven solutions, HRSA and the OPTN are modernizing processes and reinforcing a system that patients, families, and providers can trust for decades to come.

A Multi-Year Approach to Modernization

HRSA has developed a deeper look into our long-term vision for strengthening the nation’s organ donation, procurement, and transplantation system. A new webpage was created to feature a comprehensive overview of HRSA’s multi-year approach to Modernization. Visitors will also find direct links to the OPTN Discovery Task summaries and full reports. These resources capture extensive research, stakeholder input, and system analysis conducted by Discovery Task vendors to support informed decision-making as we move toward a more effective and resilient national system. HRSA is excited to share these materials with the broader community, and we remain deeply committed to advancing the critical improvements that will benefit patients and families nationwide. 

Expanding Efforts to Protect Patients

Allocation Compliance Reports for Organ Procurement Organizations (OPOs)
HRSA, in close collaboration with the OPTN, including the Board of Directors, Membership and Professional Standards Committee (MPSC), and the OPTN Allocation Out of OPTN Sequence (AOOS) Workgroup, has developed Allocation Compliance Reports for all 55 organ procurement organizations (OPOs). These reports contain patient data and will only be available internally to the OPTN and HRSA. The reports were developed following an OPTN request to have ongoing ways to monitor allocation compliance with the latest data to better meet the needs of the transplant community.

To develop these internal reports, HRSA reviews:

  • Each OPO’s organ allocation practices based on the OPTN’s analytical definition of AOOS
  • Comparisons of OPO AOOS rates to national averages
  • Patterns by organ type and where out-of-sequence offers were sent
  • Metrics such as how many transplant hospitals received offers before the first AOOS offer and acceptance rates within a 250-mile radius

The data in these reports are consistent with the AOOS dashboard available on the OPTN website. After OPTN finalizes a consensus AOOS dataset for community use, the data will be updated accordingly.

By providing actionable insights, HRSA aims to support OPTN’s oversight goals, strengthen transparency, and promote fair allocation practices across the national system.

Public Comment Open on Safety Policies 
HRSA and the OPTN have released two critical proposals for public comment aimed at improving patient safety and transparency.

Stakeholders across the transplant community are encouraged to review and provide feedback during the public comment period.

National Insights on Organ Donation Attitudes and Practices

HRSA has released the 2025 National Survey of Organ Donation Attitudes and Practices, a nationally representative assessment of public knowledge, beliefs, and decision-making related to organ, eye, and tissue donation. The report includes updated analyses on public support for donation, registration behaviors, the influence of family discussions, common misconceptions, and attitudes toward emerging donation practices.

A supplemental table provides cross-tabulated results by demographic and attitudinal groups, offering practical insights for OPOs, transplant centers, and other organizations working to strengthen community outreach and patient education. These data may also support MPSC and policy workgroups by highlighting national trends relevant to communication, transparency, and understanding of donation practices.

Read the full report (PDF - 5 MB) and view the supplemental table (XLSX - 195 KB) and public-use datasets for additional detail and analysis.

Reporting Allegations of Misconduct Social Media Campaign
Earlier this year, HRSA launched an enhanced process for reporting allegations of misconduct in the organ donation, procurement, and transplantation system. The new process makes it easier for anyone—patients, families, providers, and members of the national organ procurement and transplant network—to raise concerns by offering a clear, centralized reporting channel and improved guidance on what to report. Reports can now be submitted directly via email to OPTNComplaints@hrsa.gov, and HRSA has strengthened follow-up procedures to ensure timely review and action.

To increase awareness, HRSA is sharing this information across social media platforms and encourages members of the organ donation, procurement, and transplant community to follow and share these posts. Every report helps build a safer, more transparent system. Learn more at Reporting Allegations of Misconduct.

New Ventilated Patient Form (VPF) to Advance Safety and Accountability 

Over the past year, the OPTN community and members of the public have provided feedback on the new Ventilated Patient Form (VPF) during two public comment periods. The Office of Management and Budget (OMB) has now approved the final version of the form (PDF - 159 KB) and its accompanying instructions (XLSX - 24 KB). The VPF establishes standardized reporting on all ventilated patients referred to an Organ Procurement Organization (OPO) for potential organ donation who have a documented pronouncement of death.

This effort reflects HRSA’s commitment to improving patient safety, transparency, and accountability in the nation’s organ donation process. As OPOs update their electronic medical record (EMR) systems to ensure accurate and complete collection of the required data, HRSA is developing automated data connection (API) specifications that will allow this information to flow securely into national systems. Over time, these improvements will create a more consistent and objective view of how potential donors are identified and managed, and the impact of OPO practices on the number of deceased donor organs available for transplant. 

Expanded Communication Channels for Patients, Families, Medical Professionals, and the Public

OPTN 411: A New Call Line for Information and Assistance
Starting later this month, HRSA and the OPTN will launch OPTN 411, a new, easy-to-remember phone line for all OPTN-related questions and support. This new number will replace the current Patient Services Line and provide one central place to call for help. The Organ Center will continue to have its own separate phone line for OPOs and transplant hospitals to get assistance with placing donated organs, running the matching process, and providing transportation for donated organs.

OPTN 411 is designed to assist patients, families, caregivers, medical professionals, and OPTN members. Callers will receive clear information and be connected to the right resources quickly. The line will offer support in English and Spanish, and interpretation services will be available for other languages so more people can get help in the language they prefer.

The call line will operate Monday through Friday, from 8:30 a.m. to 6:00 p.m. Eastern Time. If you call outside of these hours, you can leave a message, and someone from the OPTN support team will return your call the next business day.

This new single hotline makes it easier for everyone to get answers, improves customer service, and strengthens communication across the OPTN community. OPTN 411 will begin service on December 29, 2025, and can be reached at 1-866-OPTN-411 (1-866-678-6411).

OPTN Website Migration - Improving the OPTN Website for a Better Experience
HRSA has moved the OPTN website to a secure, government-managed server as part of ongoing efforts to modernize and strengthen the system. This upgrade improves the site’s security, reliability, and long-term performance. The main website address (optn.transplant.hrsa.gov) has not changed, but some page links may look different during this transition.

To make sure everything works smoothly, the migration is happening in planned phases. This allows HRSA to check the accuracy of information, protect data, and fix any issues along the way. Some pages or tools may not be available right away, but no information or resources are being removed. All existing content will return once the transition is complete, which is expected in the first few months of 2026.

If you need help, HRSA has created a dedicated email inbox at OPTNWeb@hrsa.gov. You can use it to:

  • Ask questions about the website transition
  • Request help finding pages or tools
  • Report any issues you encounter
  • Share feedback or suggestions for improving the new site

After the migration is complete, HRSA will conduct usability testing and other research to make the OPTN website easier to use and more responsive to patients, caregivers, and providers. These improvements will help ensure the website continues to support transparency, trust, and a better experience for everyone involved in organ donation and transplantation.

OPTN Registration Fee Collection

HRSA has begun collecting OPTN patient registration fees following the authority granted under the new federal funding bill (HR 5371). HRSA issued invoices for registrations from Sept. 1, 2025, through Nov. 30, 2025, and transplant centers have started submitting payments. HRSA continues to work closely with transplant centers to ensure a smooth transition to the updated billing process and to provide support through the OPTN registration fee web page and the HRSA Pay.gov User Guide (PDF - 3 MB).

Reinforcing Trust Through Continued Action

As HRSA and the OPTN continue implementing modernization initiatives, the progress outlined in this update reflects a national system steadily becoming more transparent, more resilient, and more responsive to the needs of patients and providers. From strengthening oversight and improving safety policies to enhancing reporting pathways, upgrading technology and communication channels, and supporting fair and consistent allocation practices, each effort demonstrates a commitment to building trust through action. The work ahead—guided by public engagement, rigorous analysis, and collaborative problem-solving—will further reinforce a system designed to protect patients, support families, and ensure that every organ offers the greatest possible chance for life.

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