Modernization Updates

New board of directors

HRSA recently held a special election to elect a new and independent OPTN Board of Directors.

Purposeful Change, Shared Vision: HRSA’s Commitment to Stakeholder-Driven OPTN Reform

June 2025 Update

Modernization of the Organ Procurement and Transplantation Network (OPTN) aims to create a more fair, safe, and effective organ donation, procurement, and transplantation system. At the heart of this effort is stakeholder engagement, an essential component for ensuring that reforms are grounded in real-world experiences and responsive to the needs of those most affected.

Patients, clinicians, donor families, organ procurement organizations, transplant centers, histocompatibility labs, and others invested in the success and safety of the system bring critical perspectives that help us build a stronger system together. Input from the people who wait on a lifesaving phone call, the people who wake up in the middle of the night to care for a patient at bedside, and the people who transport an organ from a compassionate donor to a sick patient, provide firsthand insight into the challenges and opportunities that may arise from proposed changes.

By actively listening to stakeholders, HRSA is working to improve OPTN system performance through on-the-ground expertise from healthcare providers and facilities. This approach promotes fairness by identifying and addressing barriers within the organ procurement and transplant process—and ensures patient-centered outcomes by aligning reforms with the real needs of both donors and transplant recipients.

Modernizing the OPTN isn’t just about updating technology or policies, it’s about building a system that reflects the voices and needs of the broader organ procurement and transplant community. Stakeholder engagement ensures this process is not only informed but also collaborative.

Informing OPTN Operational Improvements: Discovery Task Orders

In September 2024, HRSA awarded multiple contracts as part of OPTN Modernization to assess the current state of the OPTN and provide actionable recommendations for improvement. These recommendations focused on enhancing patient safety, strengthening patient-centered communication, improving financial management within the OPTN, and increasing transparency and public engagement in policy development.

To inform their findings, the contractors conducted interviews with more than 90 stakeholders representing a broad spectrum of the organ procurement and transplantation community. Participants included patients, registered organ donors, families and caregivers, healthcare providers, industry experts, advocacy organizations, and members of OPTN governing and oversight bodies.

The analysis from this stakeholder engagement and discovery effort is expected to conclude by the end of the summer. HRSA will share key findings and outline next steps with the OPTN Board of Directors, the broader OPTN community, and the public. This work is a foundational step in the OPTN Modernization, and HRSA remains committed to ongoing collaboration with partners across the system to consider and implement meaningful, lasting improvements.

Patient Safety and Engagement: A Cornerstone of OPTN Modernization

Patient safety is, and must remain, at the core of organ procurement and transplantation efforts. As HRSA leads the modernization of the OPTN, prioritizing patient protection throughout the donation, procurement, and transplant process remains a top priority. Achieving this requires a system that not only operates efficiently, but also transparently, to address emerging clinical and ethical challenges.

Two key areas of focus in current patient safety discussions are allocation out of sequence (AOOS) and organ procurement practices, including normothermic regional perfusion (NRP). These complex topics reflect the evolving nature of procurement and transplant medicine, logistics, and policy. To promote transparency and support informed engagement, HRSA will launch a dedicated landing page for AOOS and plans to introduce a similar page focused on strengthening safeguards in organ procurement practices, including NRP. These pages serve as centralized resources for the public, providing background information, regular updates, and opportunities to submit feedback or questions.

HRSA continues to collaborate with the OPTN Board and its members to strengthen patient safety protections by improving policies, updating standards, and fostering open communication. This work includes reviewing and addressing safety events more transparently, increasing consistency in clinical practice through updated guidance, and engaging stakeholders early in the policy development process.

Patient safety is not a one-time priority—it is an ongoing commitment. Together, with the insight and engagement of the broader community, HRSA is working to build a more accountable, transparent, and resilient system that puts patients first.

Community Engagement to Support Effective Governance

HRSA is pleased to announce the successful completion of the 2025 OPTN Board of Directors election, which took place from May 23 to June 2, 2025. This year’s election saw strong voter participation, with more than 83 percent of voters participating, reflecting a high level of engagement from across the organ procurement and transplantation community.

The newly elected Board represents a significant step toward strengthening governance and accountability within the OPTN. Designed to reduce potential conflicts of interest and better reflect the voices of those most impacted by the system, the new Board includes patients, healthcare providers, and representatives from transplant hospitals, organ procurement organizations and histocompatibility labs, in alignment with the requirements of the OPTN Final Rule.

The elected members will begin their terms on July 1, 2025. To learn more about the new OPTN Board of Directors, please visit the OPTN Special Election web page.

HRSA extends its sincere appreciation to the Transitional Nominating Committee for their dedication in identifying and recommending a strong slate of candidates. Their efforts were pivotal in composing a more streamlined candidate slate and Board, consistent with the best practices of governance and the OPTN bylaws. We also thank the outgoing OPTN Board of Directors for their steadfast leadership and service during this pivotal period of transition and modernization.

Special Election Runoff and Officer Election

Following the conclusion of the OPTN Special Election, a tie occurred in the races for (1) the third Organ Procurement Organization (OPO) Representative on the OPTN Board of Directors and (2) the Associate Regional Councillor for Region 8. To resolve these ties, a runoff election is being held. All OPTN members are eligible to vote in the OPO runoff for the third OPO seat. However, only Region 8 members who did not participate in the initial election for Associate Councillor are eligible to vote in the runoff to resolve the tie.

In addition, the national ballot includes officer positions from among the members of the newly elected Board of Directors. The officer positions up for election by the OPTN members are president, vice president, vice president of patient and donor affairs, treasurer, and secretary.

Personal statements for candidates participating in this runoff election and election of Board officers are available on the OPTN Special Election web page. 

OPTN members with voting privileges will be able to vote virtually for candidates until Thursday, June 26, 2025, at 11:59 p.m. ET. These OPTN members received an email on June 20, 2025, with instructions on how to cast their vote.

Committee Volunteer Opportunities

In the coming days, the OPTN will seek volunteers for OPTN Committees, with terms beginning September 1, 2025. The OPTN relies on more than 300 volunteers who help shape policies to improve the nation's transplant system. We encourage you to share this opportunity with anyone who may be interested. Learn about serving on OPTN Committees.

Transitioning to a New OPTN Registration Fee Process

Earlier this spring, Congress passed the 2025 Full-Year Continuing Appropriations and Extensions Act to fund the federal government. Included in this legislation, Section 1904 grants the U.S. Department of Health and Human Services explicit legal authority to collect and distribute registration fees from OPTN member institutions to support the ongoing operations of the OPTN. These fees are paid by transplant hospitals each time a transplant candidate is added to the national waiting list.

To ensure a smooth transition, HRSA has begun direct outreach to transplant hospitals. The first step in this process is to confirm billing points of contact at each institution. Once that is complete, HRSA will provide detailed instructions for setting up accounts through Pay.gov, the secure federal payment platform that will be used to collect registration fees moving forward.

Transplant hospitals should continue paying OPTN patient registration fees to the OPTN contractor until directed by HRSA. HRSA anticipates beginning to invoice transplant hospitals for OPTN patient registration fees for transplant candidates added to the waiting list between October 1st through 31st, 2025.

HRSA is committed to making this transition as seamless as possible and will continue to provide updates, training resources, and individualized support to transplant hospitals throughout the process.

Your Voice Matters: Continuing the Conversation on OPTN Modernization

To better understand the perspectives of those directly involved in organ donation and transplantation, Dr. Raymond Lynch, Chief of HRSA’s Organ Transplant Branch, has been actively engaging with the community throughout the year. Earlier in 2025, he attended multiple OPTN Regional Meetings and led dedicated feedback sessions focused on OPTN Modernization.

Building on those conversations, Dr. Lynch also joined open forum meetings with several OPTN Committees throughout May and June. The insights gathered from these sessions have been invaluable in shaping the direction of ongoing modernization efforts and ensuring that changes reflect the real-world experiences of patients, providers, and professionals across the system.

HRSA is committed to continuing these important discussions. We invite you to connect with us at these upcoming events:

Looking Ahead: Ongoing Opportunities for Engagement 

HRSA remains deeply committed to engaging with the transplant community and the public as we continue to modernize the OPTN. As shared during the recent Board of Directors meeting, insights from the community are essential as we advance key efforts in governance, patient safety, and operations.

As we prepare to onboard a new Board of Directors, review OPTN bylaws and policies, implement corrective action plans, and modernize registration fees, HRSA is prioritizing transparent and ongoing collaboration with stakeholders. These collective efforts are critical to ensuring the OPTN evolves to meet the needs of patients, families and caregivers, and providers alike.

We will continue to share updates and opportunities for engagement through this webpage and our monthly newsletter. You are also encouraged to share input anytime via the OPTN Modernization Contact Form. Your feedback is instrumental in improving the safety and effectiveness of the nation’s organ donation, procurement, and transplantation system.

As we continue this important work, HRSA remains dedicated to listening, adapting, and making meaningful progress—together with you. 

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