Amid reports that organ donors may be at risk for having their body parts harvested while still alive and kicking, the Trump administration has launched a sweeping reformation of the U.S. organ transplant system.
The move, announced by Health and Human Services Secretary Robert F. Kennedy, Jr., comes on the heels of an investigation by the department’s Health Resources and Services Administration that revealed “disturbing” practices by a major organ procurement organization.
“Our findings show that hospitals allowed the organ procurement process to begin when patients showed signs of life, and this is horrifying,” Kennedy said in a statement.
“The organ procurement organizations that coordinate access to transplants will be held accountable. The entire system must be fixed to ensure that every potential donor’s life is treated with the sanctity it deserves.”
The administration directed the Organ Procurement and Transplantation Network – which links organ donation and transplantation professionals throughout the country – to reopen a case involving potentially preventable harm to a neurologically injured patient by the federally funded organ procurement organization serving Kentucky, southwest Ohio and part of West Virginia. The department did not name the organization.
The New York Times recently reported that the federal inquiry had begun last fall after 36-year-old Kentuckian Anthony Thomas Hoover II’s organs were pursued even as he shook his head and drew up his knees to his chest. Hoover’s sister, Donna Rohrer, had previously told NPR that she felt “betrayed by the fact that the people that were telling us he was brain dead and then he wakes up.”
Kentucky Organ Donor Affiliates, the group tied to the case, is new a part of Network for Hope: a member of the United Network for Organ Sharing and newly formed organ procurement organization. Network for Hope has criticized The Times’ reporting in a page on its website, saying it was missing “factual clarifications and critical context about organ and tissue donation.”
“We are fully committed to transparency and accountability to their regulations regarding donation after circulatory death donation…” the group said. “Our goal has always been and will remain to meet the highest ethical and medical standards in donation and transplantation.”
There were some 48,000 organ transplants in 2024, according to the United Network for Organ Sharing. Last year, it said there were more than 7,200 donation after circulatory death donors, making up 43 percent of all deceased donors. Donation after circulatory death is defined as when the donor patient is still on life support, near death, and will not recover.
It said that neither its staff nor transplant professionals are involved in the determination of death.
“Patient safety is our top priority. Network for Hope looks forward to working collaboratively with HHS and HRSA and encourages the development of policies that support the betterment of the organ transplant system as a whole,” CEO Barry Massa said in a statement sent to The Independent.
According to the Trump administration, the Biden administration’s Organ Procurement and Transplantation Network’s Membership and Professional Standards Committee closed the case without taking action.
“HRSA demanded a thorough, independent review of the organ procurement organization’s conduct and the treatment of vulnerable patients under its care. HRSA’s independent investigation revealed clear negligence after the previous OPTN Board of Directors claimed to find no major concerns in their internal review,” the department wrote.
After examining more than 350 cases were organ donation was authorized but ultimately not completed, it found that 103 showed concerning features, including 73 patients with neurological signs incompatible with organ donation.
The Times, citing interviews with health care workers and a review of internal records, audio recordings and text messages, reported that there were 12 additional cases in nine states that troubled medical workers or were being investigated.
Furthermore, the department said at least 28 patients may not have been fully dead at the time organ procurement was initiated. The investigation found evidence pointing to poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly in cases involving an overdose.
It also noted that vulnerabilities were highest in smaller and rural hospitals.
In response to the investigation’s findings, the administration has mandated corrective actions, as well as “system-level changes.”
Data regarding any safety-related stoppages of organ donation called for by families, hospital, or organ procurement organization staff must be reported to regulators and the Organ Procurement and Transplantation Network must adopt a formal procedure allowing any staff member to halt a donation process if patient safety concerns arise. The network must also update its policies.
Last September, the federal government increased oversight of the network following a House committee hearing, according to The Times.
As of 2022, 170 million Americans had registered as organ donors, according to the administration. Not everyone who registers is able to donate and only three in 1,000 people die in a way that allows for deceased organ donation.
“These findings from HHS confirm what the Trump administration has long warned: entrenched bureaucracies, outdated systems, and reckless disregard for human life have failed to protect our most vulnerable citizens,” the department wrote.
With reporting from The Associated Press
