Modernizing the OPTN: Ensuring Continuity and Strengthening the System
November 2025 Update
HRSA and the OPTN continue to advance OPTN Modernization while maintaining safe, reliable, and uninterrupted services for patients and families. This includes ensuring continuity of operations during the transition to a new multi-vendor structure, strengthening data and collaboration tools, improving safety and quality standards, and expanding communication with the organ procurement and transplant community. Together, these efforts are designed to support a more transparent, accountable, and patient-centered national system.
Ensuring Continuity During Transition
As HRSA works to modernize and strengthen the OPTN, the agency continues to transition to a new, multi-vendor operating structure. To ensure uninterrupted service when the current OPTN operations contract ends on Dec. 29, 2025, HRSA anticipates adding additional options with the existing contractor in three-month increments, for up to one year. During this period, HRSA will issue competitive task orders under the OPTN Operations IDIQ contracts established last year.
HRSA undertook this incremental strategy after careful consideration, research, and with the intent to prioritize continuity of care and services for patients, providers, and healthcare organizations. By sharing this plan in advance, HRSA aims to reassure patients, families, and professionals that there will be no disruption in organ matching or transplant services. The continuity period will allow HRSA to complete the competitive contracting process and transition OPTN functions to multiple vendors.
Invoicing for OPTN Registration Fees
The new federal funding bill (HR 5371), signed into law on Nov. 12, 2025, extends HRSA’s authority to collect OPTN patient registration fees. HRSA is preparing to send invoices to transplant centers for OPTN patient registrations that occurred as of Sept. 1, 2025. HRSA’s anticipated timeline for sending these invoices includes:
- September Invoices (patients added between Sept. 1-30): Invoices were sent on Nov. 19
- October Invoices (patients added between Oct. 1-31): Invoices sent by Dec. 5
- November Invoices (patients added between Nov. 1-30): Invoices sent by Dec. 12
All subsequent invoices will be billed around the 15th of each month. HRSA continues to communicate regularly with transplant centers directly to transition the OPTN registration fee collection process. Transplant centers can also find more information on the OPTN registration fee web page and in the HRSA Pay.gov User Guide (PDF - 3 MB).
New Initiatives to Strengthen OPTN Operations
Improving Data Collection, Access, and Use
As part of OPTN Modernization, HRSA is developing a new effort to strengthen how OPTN data are collected, managed, and shared. Today, both the OPTN and Scientific Registry of Transplant Recipients (SRTR) contractors maintain separate systems and dashboards. This can create confusion, duplicate work, and, at times, conflicting numbers for healthcare professionals, researchers, and policymakers.
Under this initiative, HRSA will bring OPTN data into a single, secure, government-managed system that serves as the “source of truth” for organ donation, procurement and transplant data. This will make it easier for OPTN members and the public to access consistent, reliable information about transplant activity and outcomes.
Hospitals, organ procurement organizations (OPOs), researchers, and federal partners will be able to use standardized data and tools to monitor performance, answer questions from patients and families, and support policy decisions. By modernizing how data are managed—and ensuring they are aligned with public health goals rather than any single vendor—this effort will improve transparency, strengthen federal oversight, and help drive better outcomes for people who depend on the nation’s organ donation, procurement, and transplant system.
HRSA is also piloting new ways to collect data earlier in the organ donation process. A new ventilated patient form (VPF), now in the final approval process, will test standardized reporting on all ventilated patients with a documented pronouncement of death. As part of this pilot, HRSA will explore automated data connections (APIs) so information from the VPF can flow directly and securely into national systems. Over time, this will provide a more comprehensive and objective picture of how potential donors are identified by hospitals and OPOs and how OPO practices affect the number of deceased donor organs available for patients in need.
Modernizing OPTN Collaboration Infrastructure and Tools
HRSA is creating a new OPTN Collaboration Platform. This secure environment will serve as the official home for OPTN governance and day-to-day collaboration, including work by the Board of Directors, committees, and advisory groups. By moving to this new platform with dedicated OPTN email addresses and collaboration tools, the OPTN will be less dependent on any single vendor and better positioned to operate as an independent, transparent national resource.
For OPTN Board members and volunteers, the platform will provide modern, easy-to-use tools to support meetings, document review, and group communication in one organized place. Instead of juggling multiple systems or searching for the latest version of materials, Board members and committee volunteers will be able to focus their time on discussion, decision-making, and applying their expertise.
This investment will also strengthen information security, improve record-keeping, and create clearer, more accessible documentation of OPTN decisions and actions. Over time, the new collaboration platform will help the OPTN govern more efficiently and effectively, making the best use of the time and expertise of its leaders and volunteers while supporting better outcomes for patients, families, and the broader transplant community.
Developing National Safety and Quality Standards for OPTN Members
To further strengthen safety, consistency, and accountability across the national transplant system, HRSA has launched an effort with the HHS’s Federally Funded Research and Development Corporation (FFRDC) (operated by MITRE) to develop safety and quality standards for OPTN member institutions. This work will focus first on OPOs and then expand to transplant centers and histocompatibility laboratories, with the goal of setting shared expectations for workforce training, patient safety practices, quality improvement, and data and documentation.
The project will draw on existing statutory and regulatory requirements, OPTN policies, and leading safety frameworks from across healthcare, combined with input from OPTN leaders, clinicians, patients, donor families, and professional societies. The result will be practical standards and review tools that build on what is already working well while addressing known gaps. Over time, these standards are intended to support more consistent performance across all OPTN members, reduce preventable errors, and give patients and families greater confidence that they will receive safe, high-quality care wherever they receive organ donation, procurement, or transplant care.
Securing and Migrating the OPTN Matching System to the Cloud
HRSA also recently awarded a contract to support migration of the OPTN Matching System, to a secure, government-managed cloud environment. This upgrade will enhance reliability, strengthen cybersecurity, and improve oversight, offering greater assurance to patients, families, and healthcare partners nationwide.
Expanding Channels for Communication
Over the past year, HRSA and the OPTN have expanded the ways the transplant community can stay informed and connected. Together, these communication tools create more open channels for dialogue and engagement so that every stakeholder has access to the same timely, reliable information.
New OPTN-Specific Distribution Channel
HRSA has launched a new communications listserv to deliver timely updates directly to the OPTN community. All OPTN members were automatically enrolled based on their membership points of contact. To ensure you continue receiving messages—including policy notices, regular updates, and safety alerts—please add optn@public.govdelivery.com to your safe senders list.
OPTN Patient Services Line
As part of OPTN Modernization, HRSA has awarded a new contract to support the patient services line for the OPTN. This line remains a centralized point of contact where patients, families, transplant professionals, and members of the public can get general information and ask questions related to organ donation and transplantation. The service will continue to be available in English and Spanish, with additional languages supported through interpretation services so that more people can get assistance in the language they are most comfortable using.
The new contract also strengthens the tools behind the call line. A modern customer relationship management (CRM) system will help document and track calls, identify common concerns, and generate performance metrics. These improvements will support transparency reporting, quality improvement, and customer satisfaction, helping HRSA and the OPTN respond more quickly to issues, better understand community needs, and improve the experience for everyone who relies on the national system.
OPTN Website Migration (Launching December 2025)
As part of HRSA’s modernization efforts, we have assumed expanded oversight of the OPTN, including management of its digital presence. The OPTN website will be migrated to a new, secure government-managed server to enhance efficiency, reliability and performance, strengthen data security, and support long-term system stability.
The home page link to the OPTN website (optn.transplant.hrsa.gov) will not change, but some other links may. If you have issues or questions finding content, please contact OPTNWeb@hrsa.gov.
Following the migration, in the Spring, HRSA will conduct formative research to guide enhanced design and functionality of the OPTN website. HRSA is focused on exploring: how the site can best meet the needs of patients, caregivers, and providers; what functionality will support transparency in governance; and how the improved website will serve as a trusted hub for information and engagement across the network.
Innovations to Improve OPTN Outcomes
As described in previous modernization updates, HRSA has initiated projects to address key opportunities to improve OPTN operations. Below are high-level insights from these efforts that will be shared with the OPTN for further review and consideration.
Improving Organ Transplantation Logistics and Transportation
HRSA engaged HHS’s Health FFRDC to assess how organs are transported today and identify opportunities to make the system safer, more reliable, and more transparent for patients and families. Today, organ logistics depend on a complex network of OPOs, transplant hospitals, airlines, charter aviation, and couriers. While clinical care is regulated and closely monitored, there is no consistent, nationwide view of how donated organs move once they leave the donor hospital, including when and where delays happen or how often transportation issues contribute to organs not being transplanted.
The FFRDC’s analysis shows that proven technologies already used in healthcare and commercial shipping, such as barcodes and QR codes, GPS-based trackers, and temperature monitors, could be deployed more consistently to improve organ safety. The study also highlights the need for better data. Today, information about each organ’s journey (such as mode of transport, time in transit, temperature, or reasons for non-use related to logistics) is often fragmented across different systems or recorded manually. This makes it difficult to see problems early, respond in real time, or learn from them across the national system.
Building on these findings, HRSA will work with the OPTN community to develop clear, technology-neutral system requirements for organ transport. These requirements will focus on ensuring that every organ can be reliably tracked from donor to recipient, that key transport and temperature information is captured and shared securely, and that a centralized “visibility” solution can provide real-time alerts when something goes wrong. Over time, this work will support better analysis of delays and missed transplants, reduce preventable losses, and help ensure that every donated organ has the best possible chance to reach the patient who needs it.
Evaluating Organ Allocation Policy
To ensure that future OPTN policies power better outcomes for patients and families, HRSA has supported the development of a comprehensive Organ Allocation Policy Evaluation Framework through HHS’s Health FFRDC. This framework gives HHS a structured, repeatable way to assess how the OPTN creates, implements, and monitors major organ allocation policies by examining what OPTN designed the policy to do, how the OPTN and contractors implemented it across OPTN members, and how the policy affects patients, donors, and transplant programs over time.
The framework is organized around three core objectives:
- Policy content: What the OPTN policy changes and why
- Implementation: How OPOs, transplant programs, and histocompatibility labs understood and carried out the new OPTN policy, including policy compliance
- Impact: How patient access, outcomes, organ utilization, organizational performance, and costs change before and after an OPTN policy takes effect
The framework draws on existing data sources, such as the OPTN data and CMS OPO performance reports, alongside qualitative input from stakeholders. This will support rigorous analyses that go beyond basic monitoring reports. HRSA will use this framework to guide in-depth evaluations of key OPTN organ allocation policies, identify unintended consequences earlier, and support the OPTN with transparent, data-driven policy refinements. This work is intended to improve the OPTN’s fairness and consistency in how organs are allocated nationwide, strengthen accountability for OPTN policy performance, and ultimately contribute to better outcomes for patients waiting for a life-saving transplant.
Promoting Safety and Fairness Across the National System
Congress, HHS, and the Administration are steadfast in our support of a safe and fair system for all organ donation, procurement, and transplant patients and their families. As HRSA testified in the House Energy and Commerce Hearing in July 2025, HRSA and CMS continue to investigate serious whistleblower allegations related to organ procurement safety and practices. Recent announcements from Congress underline the importance of fully investigating patient safety, fairness, and fraud allegations to protect patients and families and public trust.
HRSA appreciates the dedication of OPTN Board Members and volunteers in investigating allegations and fulfilling their duty to ensure compliance with OPTN policies and obligations.
Allocation Out of OPTN Sequence (AOOS) Update
HRSA and the OPTN continue to strengthen oversight and promote consistent performance across OPOs and transplant programs through the OPTN AOOS Workgroup. Current efforts focus on refining tools that help members understand expectations, track compliance, and identify opportunities for improvement. This includes developing enhanced dashboards and allocation compliance reports to provide clearer, more actionable feedback. Additional details on new AOOS resources will be shared in future communications as they are finalized by HRSA and the OPTN.
Protecting Donors and Their Families Through Safer Donation After Circulatory Death (DCD) Practices
Following serious events earlier this year, the OPTN verified rare cases of “autoresuscitation,” which is a brief, unexpected return of circulation or breathing.
Until new policies are finalized, the OPTN has asked OPOs and transplant programs (PDF - 97 KB) to:
- Follow a five-minute waiting and confirmation period before surgical incision.
- Conduct joint education, pre-procedure huddles, and contingency planning.
- Promptly report any autoresuscitation or unplanned pauses to the OPTN.
This guidance was distributed directly to transplant hospitals and programs, OPOs, laboratories, and public organizations that support organ donation, procurement, and transplantation, and has been posted on the OPTN’s Strengthening Organ Donation and Procurement Safety web page.
Meanwhile, a multidisciplinary workgroup is developing formal policy proposals to clarify hospital and OPO roles, standardize consent language, reinforce timeouts and confirmation periods before incision, and require safety reporting. These steps promote safe, ethical, and consistent care for all patients who may become deceased organ donors, build public confidence in the nation’s organ donation and transplant system, and reflect the belief that communication and transparency are essential to patient safety and public trust.
The Path Forward: A Stronger, More Transparent OPTN
HRSA’s work to modernize the OPTN is focused on building a safer, fairer, and more reliable organ procurement and transplant system for patients and families. Ensuring continuity of core services, modernizing data and collaboration tools, strengthening safety and quality standards, and expanding communication are all part of building a system that can better serve the public.
As new milestones are reached—such as adding to the multi-vendor structure, launching new technology platforms, and implementing updated policies—HRSA will continue to share regular updates with OPTN members and the broader community.
Ongoing engagement from patients, donor families, OPOs, transplant centers, and other stakeholders remains essential to shaping a modern OPTN that is worthy of the lives it is entrusted to serve.