Building a Safer, More Accountable Transplant System

August 2026 update

OPTN Modernization is a coordinated effort to strengthen the nation’s organ donation, procurement, and transplant system through safer care, stronger accountability, better data and technology, and more effective governance. Across these areas, HRSA and the OPTN are updating longstanding systems, policies, and oversight approaches to better reflect current clinical practice and public health needs. This work is focused not only on modernizing individual processes, but also on strengthening how the national transplant system functions as a whole—giving patients, families, healthcare professionals, and federal regulators better information, clearer accountability, and more reliable tools for supporting donation and transplantation.

Key developments this month

• Patient safety protections continue to advance. The OPTN Board approved new policy requirements for donation after circulatory death (DCD) that strengthen protections for potential donor patients and promote greater consistency and accountability in DCD practices.
• Modernization of national data collection is moving toward implementation. Beginning October 1, OPOs will transition to the Ventilated Patient Form, replacing two legacy reporting mechanisms with a more standardized approach designed to improve data quality while reducing reporting burden.
• Governance and program-management structures continue to evolve. All OPTN committees are now using OPTN 360, HRSA has awarded the OPTN Project Management Office task order, and governance changes continue to clarify responsibilities within the modernized OPTN structure.
• Greater transparency is being built into how the system is governed and funded. HRSA is seeking public input on Board and committee applications and forms, and beginning in October HRSA will publish quarterly information on patient registration fees collected by transplant center and the activities those fees support.

For patients, families, and the public

Improving organ transport: Implementing FAA working group recommendations

HRSA is moving forward on recommendations from the FAA-led Organ Transport Working Group, which brought together federal agencies, airlines, organ procurement organizations (OPOs), transplant hospitals, couriers, and other stakeholders. The group’s final report includes 20 recommendations to improve access, logistics, communication, education, and reporting for organs transported on commercial airlines. Five recommendations are directed specifically to HRSA, including improving incident-report sharing, establishing ongoing cross-sector coordination, and strengthening and standardizing organ transport data collection.

HRSA is aligning this work with OPTN modernization and its organ-transport discovery efforts, with a focus on building the data and technology foundation needed to better understand transport failures and improve coordination. For the latest information, visit the OPTN’s organ transport webpage.

Stronger oversight for increased transparency and accountability

HHS to decertify, select new OPO contractor to serve Kentucky

HHS announced it is moving to decertify Network for Hope, the OPO contractor serving Kentucky and parts of Indiana, Ohio, and West Virginia, after multiple reviews found persistent patient safety deficiencies that were not corrected despite a year of oversight and required corrective actions. OPOs are the federally designated organizations responsible for recovering donated organs for transplantation in specific geographic regions. Under CMS regulations, if the decertification becomes final after the applicable due process and appeals, a new OPO contractor would be selected through a competitive process, with organ donation services continuing through any transition.

All committees onboarded on OPTN 360

All OPTN committees have now been onboarded to OPTN 360, the shared collaboration platform that supports committee work between meetings. Since onboarding began, committees have used the platform to access meeting materials, review documents, provide feedback, and collaborate asynchronously on policy and operational topics. Expanding OPTN 360 to all committees establishes a consistent collaboration experience across the OPTN and provides additional opportunities for members to engage in committee activities outside of scheduled meetings.

Public comment open on OPTN Board and committee applications and forms

HRSA is seeking public comment on a proposed information collection for applications and related forms for individuals serving on the OPTN Board of Directors and its committees. The proposed collection includes Board and committee applications as well as conflict-of-interest, attestation, code of conduct, and confidentiality forms. The comment period is open until October 5, 2026.

Operational updates for OPTN members

OPTN Board approves policy changes for donation after circulatory death

The OPTN Board of Directors approved policy changes related to donation after circulatory death (DCD) that strengthen protections for potential donor patients throughout the DCD process. The changes establish clearer patient safety protections, enhance information provided to potential donor families, and promote greater consistency and accountability in DCD practices.

HRSA awards Program Management Office Task Order

HRSA awarded the Program Management Office (PMO) Task Order to PCI Professional Services. The award establishes a centralized PMO to provide program management, strategic planning, and coordination support across the OPTN. A dedicated PMO strengthens coordination and collaboration across the OPTN’s multi-vendor environment, helping ensure work is aligned.

Upcoming transition to Ventilated Patient Form for all OPOs

As part of OPTN Modernization, the OPTN is transitioning to the Ventilated Patient Form (VPF) to support a more streamlined, standardized approach to collecting data from OPOs about patients referred for potential organ donation. The transition is designed to improve the quality and consistency of national data while reducing reporting burden. As part of this change, the OPTN is retiring the legacy Death Notification Registration (DNR) form and the Monthly Donation Data Report: Reported Deaths (DDDR). The change does not affect the Donation Donor Registration (DDR) form, which will continue to be used.

FY 2027 OPTN patient registration fee

On August 11, HRSA approved the OPTN Board of Directors’ recommended Fiscal Year (FY) 2027 patient registration fee of $1,268 per transplant candidate, up from $1,036 in FY2026. The Board voted 26–1 in favor of the recommended fee, which will take effect October 1, 2026, for transplant candidates added to the waitlist on or after that date. The fee increase supports implementation of critical Board-approved policies and required Secretarial directives. Learn more about OPTN registration fees.

Revisions to the OPTN Management and Membership Policies

The OPTN Board of Directors have approved revisions to the OPTN Management and Membership Policies related to Membership and Professional Standards Committee (MPSC) review and approval processes.

OPTN Board of Directors to meet in-person in September

The OPTN Board of Directors will meet in person on September 28-29, 2026. To support public access and transparency, open sessions of the meeting will be available via livestream for public viewing. The meeting agenda and livestream information will be posted on the OPTN Events site closer to the meeting.

Moving forward together

OPTN Modernization is moving from foundational changes in governance, oversight, program management, and data infrastructure toward implementation across the national transplant system.

In the months ahead, this work will continue to focus on translating those structural changes into clearer accountability, stronger patient protections, better information about system performance, more consistent national data, and more effective tools for the professionals and organizations responsible for donation and transplantation.

HRSA remains committed to engaging patients, families, clinicians, OPOs, transplant hospitals, and other stakeholders as this work advances. Continued collaboration will be essential to ensuring that modernization produces a transplant system that is safer, more transparent, more responsive, and better equipped to meet the needs of the people who rely on it.