Government report on U.S. transplant system shows desperate need for change

The Washington Post recently shocked the medical world with its story of a government report that paints a scary picture of the system used to manage organs for transplantation.

The Washington Post article, which primarily focuses on questions about the technology used by the nation’s transplant system, suggests that technology is insecure and unreliable, and can result in inefficiencies and mistakes. One shocking fact reported in the article: more than one in five donated kidneys go to waste in this country, twice the rate found in the United Kingdom and 2.6 times the rate in the eight countries of the Eurotransplant consortium.

The article reports on an analysis conducted by the White House’s U.S. Digital Service, which recommended that the government “break up the current monopoly” held by the United Network for Organ Sharing (UNOS), the nonprofit organization that has operated the transplant system for nearly four decades.

We are in no position to judge the effectiveness of UNOS’s technology. However we are disturbed that the U.S. “discard rate” is so much higher than that of other western nations.

Consider the facts: About 90,000 people are waiting for a kidney transplant in this country. Nearly 5,000 die each year, waiting for that kidney. And yet, in 2020 more than 5,000 kidneys were discarded.

There are many reasons for the high discard rate. An article in “Nephrology News & Issues” reports that some organs are discarded over regulatory issues or the quality of each organ.

We wonder how many organs are discarded because they exceed their shelf life. Though it’s odd to think about it this way, donated organs only last so long. Science has found ways to increase the shelf life of a kidney from 8 hours to 21 hours. But even that does not allow much room for error.

That’s why Methuselah Foundation supports X-Therma’s work to extend the useful life of donor organs by developing new ways to preserve them. While the traditional preservation technique involves ice, that can cause what most consumers call “freezer burn” that makes the organ useless.

X-Therma is working on a novel ice-prevention solution that is the first step towards safer organ transport and long-term biobanking. It could enable us to use organs for days or weeks, not just hours. 

The work X-Therma is doing is absolutely critical to extending the human lifespan. Sometimes, people’s organs fail.  Replacing them can allow a person to live several more productive years or decades.

This is the kind of promise we imagined when we developed the seven strategies that guide Methuselah Foundation investments, planning and policies. In particular, the need for longer organ shelf life is an example of “new parts for people,” a strategy focused on technologies to make available replacement parts of our bodies, including organs, cartilage, bones and vasculature. We envision a day when replacing organs will be as easy as replacing parts in a car.

An important step towards that goal is making sure the transplantation system is operating efficiently – and the organs last as long as possible.

It is one key problem we must overcome to reach our goal of making 90 the new 50 by 2030.