“A gut check on reforms to organ transplant system,” should cause grave concern. Our government censors important publicly funded research due to be presented at the American Transplant Congress.

It is encouraging to see our industry’s deep concerns reflected on a powerful news media platform like the Globe’s. Thousands of Americans who care passionately about the life-saving gift of transplantation will see the coverage and take heart that some in the media “finally get it.” The editorial is also a signal to the Centers for Medicare and Medicaid Services (CMS) that they are now under a spotlight, and can’t keep ignoring the science indefinitely.

Both the United States Senate Finance Committee, whose faulty conclusions the editorial cites, and CMS have promulgated a system whose application in 2026 will cause chaos. Peer-reviewed censored science shows the metrics that evaluate Organ Procurement Organizations are flawed. No one in the system wants to defend failing organizations but the reality is CMS cannot tell which are performing well or not.

The Globe, Congress and the people should be asking why?

Additionally, we are compelled to point out that the Globe editorial assumed certain donation and transplant “facts” because they had been presented at a United States Senate hearing. We believe the Globe’s own Washington DC bureau would know that hearings today often have their Reports and media release written before a word of hand-picked so-called testimony is heard. Absurdity reached its zenith when Senator Wyden asked CMS to have Tier 1 OPOs (allegedly performing the best) immediately take over Tier 3 (underperforming). Why is this absurd? Leaving aside the faulty metrics that establish the Tiers in the first place, the data is two years old and thirty of the 55 OPOs change tiers every year. Therefore, Senator Wyden could be advocating a current Tier 3 take over a current Tier 1. It would be laughable if it weren’t life and death.

Further, the assertion in Congressional testimony that an additional 28,000 transplants are possible is grossly out of date and reflects a flawed understanding of how organ donation works and reveals a faulty assumption that every person who has died in a hospital is a “potential donor,” even if they were not medically cleared. The 28,000-transplant number was the result of a “sponsored content” study that is not supported by responsible science. It was presented to the Committee as legitimate science, but it was never peer-reviewed or subjected to any tests of its credibility.

There is nothing more heartbreaking than someone on the organ donation transplant list dying before they had their turn to receive a donated organ. But the vast majority of waiting list fatalities are due to the sad fact that less than 1% of all deaths in the U.S. occur in ways clinically compatible with organ donation. People who die of cancer, sepsis, certain infectious diseases, or organ failure cannot be cleared for donation by the OPO based on medical criteria established by transplant physicians for the safety of their patients.

The National Academies of Sciences, Engineering and Medicine (NASEM), looked at the organ transplant system extensively in 2022 and recommended reforms based on science and statistics in their landmark study Realizing the Promise of Equity in the Organ Transplantation System. It raised key issues that are being ignored.

From the NASEM report: “While waiting lists remain long and many listed individuals die while awaiting an organ every day, too many donated organs that are procured and offered to patients at transplant centers are not accepted—leaving thousands of potentially lifesaving donated organs unused every year. Evidence indicates that many, if not a large majority, of unused organs could be successfully transplanted and benefit patients. This problem is much more prominent in the United States than in many other countries. For example, the overall nonuse rate in the United States is twice that in France. In the United States, on average, patients who die waiting for a kidney had offers for 16 kidneys that were ultimately transplanted into other patients, indicating that many transplant centers refuse viable kidney offers on behalf of those on the waiting list.”

NASEM has correctly identified the primary culprit in the unavailability of organs for those on the organ transplant list. But CMS’ flawed rule for ranking and recertifying the 56 regional Organ Procurement Organizations (OPOs) was not based on NASEM’s study. Instead it was based on suggestions from a group of organ transplant activists, well-connected on Wall Street and Washington D.C. but lacking in medical credentials, who tell their followers that “underperforming OPOs” cause organ shortages.

CMS’ rule has raised concerns throughout the organ transplant community across the nation. If its flaws are not corrected before the first wave of decertifications begins in April 2026, as OPOs are unjustly closed down, Federal judges, will decide the ultimate outcomes of CMS’ rulemaking, creating even more uncertainty and inconsistency.

Further, as the Boston Globe pointed out, transplant surgeons’ concerns grew when, at the recent annual meeting of the American Transplant Congress early June, CMS unexpectedly ordered researchers from the Scientific Registry of Transplant Recipients (SRTR) and the Organ Procurement and Transplantation Network (OPTN) to withdraw six peer-reviewed papers that directly or indirectly raised key questions about the CMS rule’s flawed metrics and the potential to skew outcomes. Among many key findings, these peer-reviewed studies said that if CMS goes forward with its rule, well-performing organ procurement organizations would be ranked below poor-performing OPOs, and that large OPOs were at a structural disadvantage against smaller OPOs.

Presentations of six key papers at the American Transplant Congress were abruptly canceled, but conference participants had already downloaded abstracts of each paper, so the 1,000 transplant surgeons, researchers, lab directors, vendors, and other US organ transplant system leaders in attendance could see exactly what CMS was doing to protect its rule from critical scientific scrutiny. We call on all responsible news agencies to investigate why politics is winning over science in a life and death health issue.

The Boston Globe has made a welcome start to expand the public scrutiny of what exactly is going on in public oversight of the donation and transplant system. We urge you to lead the mainstream media in a full examination of how and why politics is topping peer- reviewed science in organ donation and transplant.

For more information:

LINK TO CENSORED RESEARCH PAGE

LINK TO SID&T FACTS AND REFORM