GAO Report Calls for Improvements to National Organ Transplant System

A new report from the U.S. Government Accountability Office (GAO) indicates that the Department of Health and Human Services (HHS) needs to take further action to enhance the nation’s organ transplantation program, which serves over 100,000 individuals on waiting lists as of May 2025. The GAO’s findings, released on January 22, 2026, highlight areas within HHS’s modernization initiative that require more detailed planning and risk assessment to ensure the effective and safe allocation of life-saving organs.

The GAO’s review focused on HHS’s efforts to identify and address weaknesses in organ allocation services, a system overseen by the department. While HHS has initiated a modernization effort, including recent contracts to assess issues such as inequitable organ allocation and insufficient oversight of serious events, a lack of concrete plans for the subsequent phases of this initiative has been identified. Specifically, the report points out that HHS has not yet developed comprehensive strategies to implement reforms that would address these identified weaknesses, a critical step for improving the delivery of organs to patients in urgent need.

Further concerns raised by the GAO relate to a contractor that provides supplementary services to transplant programs outside of its primary HHS contract. This contractor charges a monthly fee for services such as data analytics designed to assist transplant programs in managing their patient waiting lists. In fiscal year 2024 alone, approximately $9.6 million was collected from transplant programs through this fee. The GAO found that HHS has not adequately assessed the potential risks associated with these supplementary services and the associated fees. This oversight gap raises questions about whether these services should be part of the contractor’s main agreement with HHS and whether transplant programs are aware that the fee is optional. A thorough risk assessment by HHS is deemed necessary to ensure effective oversight of the contractor’s crucial role in the organ transplantation process.

The report also examined the effectiveness of a coordination group established by HHS in 2021 to improve the organ transplantation system. While the group, overseen by two HHS agencies, has an action plan, the GAO found that it lacks specific, actionable steps with defined milestone completion dates and measures to track progress. Implementing these elements, as stipulated by the group’s charter, would significantly enhance HHS’s ability to improve the organ transplantation system through coordinated inter-agency efforts.

In response to its findings, the GAO has issued three recommendations to HHS. The department is urged to develop detailed plans for the next phase of its modernization initiative, which should outline how reforms will address identified weaknesses. Additionally, HHS is recommended to assess the risks associated with the contractor’s supplementary services and associated fees, making appropriate changes to mitigate these risks. Finally, the GAO recommends that HHS ensure its coordination group’s action plan includes specific, actionable steps with clear milestones and success metrics. HHS has reportedly agreed with these recommendations.

The organ transplantation system is a critical component of healthcare for individuals suffering from severe organ failure. The GAO’s report underscores the importance of continued vigilance and strategic planning to ensure that this lifesaving program operates as efficiently and equitably as possible. Residents can stay informed about HHS’s progress in implementing these recommendations, as they are expected to directly impact the operations of the national organ transplant network.

Article by Mel Anara, based upon information from the U.S. Government Accountability Office.

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