Organ procurement centers (OPOs) are responding to changes in their performance evaluations (by Bae, Sweat, Melcher and Ashlagi in JAMA Surgery)

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Bae H, Sweat KR, Melcher ML, Ashlagi I. Organ Procurement Following the Centers for Medicare and Medicaid Services Performance Evaluations. JAMA Surg. Published online November 19, 2025. doi:10.1001/jamasurg.2025.5074 

"In 2024, 4639 patients died in the United States while waiting for a transplant from deceased donors.1 Organ procurement organizations (OPOs) are government contractors responsible for identifying potential donors in a geographical region, recovering their organs, and implementing the offering processes to patients on the waiting list. In 2020, 10% of potential donors—individuals younger than 76 years with inpatient death and organs suitable for transplant—became organ donors, suggesting an opportunity to increase donation and transplant rates.2

"Toward this goal, the Centers for Medicare and Medicaid Services issued a final rule in December 2020 to increase transparency of OPO performances by monitoring several metrics. OPOs are placed into 3 tiers based on donation rate and donor age–adjusted transplant rates, although acceptance of organ offers is up to patients and transplant centers. OPOs that perform poorly on both metrics are placed into tier 3 and are at risk of decertification in 2026.3 This longitudinal study examines changes in OPOs’ organ recovery practices following the initial report released in September 2021, focusing on the number and quality of organs recovered and the resulting transplant rates. 

 

 

 

 

 

 

 "The findings suggest that the 2021 release of the report on OPO performance was associated with increased organ recovery among low-performing OPOs, narrowing the gap in organ donation with high-performing OPOs. Even though the gap in the transplant rate has narrowed, much of it is linked to increased organ recovery from older donors, which may limit improvements in transplant rates. This is despite an increase in organs placed out of sequence by low-performing OPOs."