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Medicare proposes new transplant system rules that might spur use of less-than-perfect organs

WASHINGTON (AP) 鈥 The government proposed new rules for the Wednesday that aim to increase use of and set additional safety standards for donor groups.

The Centers for Medicare and Medicaid Services said the proposal would strengthen its oversight of organ procurement organizations or OPOs, groups that retrieve organs from deceased donors.

More than 100,000 people are on the U.S. transplant list, the vast majority seeking a kidney, and thousands will die waiting for a new organ. Wednesday鈥檚 move is part of an of the complex transplant system that administration.

But it comes after donations from the deceased dropped last year for the first time in over a decade, sparking concern about in the system. While organ transplants have been rising 鈥- just over 49,000 last year compared with 48,150 in 2024 鈥- that year-over-year increase also slowed.

鈥淓very missed opportunity for organ donation is a life lost,鈥 CMS Administrator Dr. Mehmet Oz said in a statement Wednesday.

He said the proposed rule, expected to be finalized later in the year, 鈥渟trengthens accountability, clarifies expectations and gives us stronger tools to remove underperforming organizations, protect patients and honor the incredible gift of life.鈥

In a step toward more potentially usable organs, the proposal urges maximizing the use of 鈥渕edically complex organs,鈥 typically those from older or sicker donors. CMS would add new requirements for how OPOs track the retrieval and usage of those less-than-perfect organs, which the agency said may need 鈥渟pecial or additional considerations” in finding an appropriate recipient.

Many OPOs already have increased retrievals of those less-than-perfect organs, especially kidneys. For example, a less-than-perfect donated kidney might not be good enough to last the lifetime of a young recipient but it could give an older, sicker patient, who might not get another offer, some time off dialysis. Yet for a variety of reasons, many transplant centers don鈥檛 accept medically complex donated organs even when medical criteria suggest they鈥檇 be a good match for a patient.

Jeff Trageser, president of the Association of Organ Procurement Organizations, said Wednesday that he was 鈥渃autiously optimistic鈥 a clearer definition of these donors and organs would help encourage their use both by OPOs and by hospitals.

鈥淚f we鈥檙e going to look at maximizing opportunities to get people off the transplant list we鈥檝e got to be sure hospitals are supporting donation, helping us to manage those medically complex donors, and transplant centers have mechanisms in place where they can make use of those,鈥 he said.

CMS officials didn鈥檛 respond when asked if similar requirements were planned for transplant centers or donor hospitals.

Among other steps in the proposed rule are new definitions of what constitute 鈥渦nsound medical practices鈥 for organ-handling and patient safety, criteria that CMS uses in regulating and certifying organ groups.

Those are in addition to other safeguards being adopted by OPOs and under consideration by another government agency after some rare but scary reports of patients prepared for organ retrieval despite showing signs of life. Those planned retrievals were stopped but they , prompting thousands of people to remove their names from donor lists last year.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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