A dispute regarding data usage could potentially disrupt the flow of lifesaving organs to 63 transplant centers in the United States. This conflict poses another challenge to an already troubled transplant system, which the government has pledged to overhaul.
The United Network for Organ Sharing (UNOS), a nonprofit organization responsible for managing the system, has threatened to revoke the access of Buckeye Transplant Services, an organ-screening company, to their complex computer network.
This network facilitates the distribution of organs such as kidneys, livers, hearts, and lungs across the country. UNOS has set a deadline for Buckeye to comply with their demands concerning the use of transplant data, and failure to reach an agreement could leave 63 transplant centers without Buckeye’s services.
Jared Ackley, the president of Buckeye, expressed concern for critically ill patients awaiting transplants, stating that “people would die” without the timely evaluation of organs by Buckeye.
Transplant centers do not have the capacity to handle this sudden loss of services, and the consequences could be dire.
At the center of the dispute is UNOS’s claim that Buckeye’s automated tool accesses data from their computers without authorization. UNOS argues that once this occurs, they cannot ensure the security or appropriate use of the information.
Buckeye, on the other hand, maintains its innocence and asserts that other organizations in the transplant system engage in similar practices.
In response, Buckeye has filed a lawsuit against UNOS, seeking an injunction to prevent them from cutting off access to the computer network that coordinates organ movement. Buckeye argues that UNOS, as a competitor offering the same data to transplant centers, has already caused financial losses for the company.
The impact on patients at prominent transplant hospitals, including Stanford, Duke, and the University of California at San Francisco, is a topic of debate among transplant professionals as the Wednesday deadline approaches.
Hospitals would be forced to assume the responsibility of organ screening, arranging urgent transportation, and setting up operating rooms or find an alternative company promptly.
Jason Livingston, UNOS’s general counsel, emphasized that cutting off Buckeye’s access is a last resort after two months of negotiations. However, he acknowledged that such a move could strain hospital staff and cause delays, though guarantees cannot be made.
While the dispute primarily involves UNOS and Buckeye, the federal Health Resources and Services Administration (HRSA) has been involved in the talks. Elana Ross, a spokesperson for HRSA, stated that if disruptions occur, the organization will hold UNOS accountable for its contractual obligations.
In March, HRSA announced plans to reform the beleaguered U.S. transplant system, including the potential dissolution of UNOS’s 37-year monopoly as the network’s operator.
The current system has long been criticized for its inadequacy, with nearly 104,000 people on the organ waiting list and 22 deaths occurring daily. Issues such as organ wastage, transit-related damage, technology failures, and insufficient accountability plague the system.
Buckeye expressed interest in bidding for a part of the contract currently held by UNOS, provided they can offer the required technology. The company’s lawsuit argues that UNOS intends to suppress the development of technology that could potentially replace their system.
With advancements in technology and expanded reach for organ procurement, transplant centers now receive a greater number of offers, leading to increased pressure on screeners.
They must carefully sift through numerous offers to identify the organs suitable for their patients, which can be a time-consuming and labor-intensive process.
Buckeye, the largest organ-screening company in the United States, with 180 employees nationwide, has been in operation since 2008. In 2022, the company evaluated 280,000 organ offers and participated in 5,900 organ transplants. UNOS reported that U.S. transplant hospitals conducted nearly 43,000 transplants that year, a record high.
Additionally, Buckeye collects and provides data on organ offers, acceptances, and other relevant information to transplant center clients, allowing them to review the decision-making process and potentially revise their organ acceptance criteria.
UNOS’s general counsel, Jason Livingston, emphasized that the data belongs to the Organ Procurement and Transplantation Network, which UNOS manages. Transplant centers can obtain the data from UNOS, but Buckeye is not allowed to collect and sell it to their customers in bulk.
Livingston expressed concerns about the security, potential misuse, and storage of the data if Buckeye continues to access and scrape it. He also suggested that Buckeye could create an alternative database using the information.
Livingston stated that Buckeye’s actions involve vulnerable patient and donor data, which is substantial in volume. According to him, no other organization within the transplant network employs an automated tool similar to Buckeye’s.
Buckeye and their attorney contested these claims, arguing that the company is being unfairly singled out for practices common among researchers, organ-procurement organizations, and other entities in the transplant industry. Ackley cited at least three other vendors in their field that offer similar services to transplant centers.
Kristy Edwards, the CEO of All Call Nursing, a smaller competitor, explained that she provides reports to her 27 clients based on each day’s DonorNet activity to avoid violating UNOS rules regarding data storage.