HHS finalizes rules to increase living-donor organ transplants

HHS on Friday finalized rulemaking that aims to increase living organ donations by providing more financial support to donors.

The policies have widespread support from stakeholders, and HHS didn’t make many changes from the initial versions. Under the proposals, living donors would be reimbursed for the expenses they take on while they’re hospitalized and recovering, such as lost wages or childcare.

More donors would qualify for the reimbursement, as the threshold for eligibility will be raised from 300% of the HHS Poverty Guidelines to 350%.

That could encourage more people to become donors by reducing financial disincentives that make it cost-prohibitive for people to donate, HHS said. The agency expects the changes to save the federal government $68 million over 10 years resulting from a 20% increase in living-donor kidney transplants.

“We believe that there are many potential living organ donors who would like to donate an organ to a family member or friend or a complete stranger, but cannot afford the loss of income incurred during the required weeks out of work needed for a transplant surgery and the recovery time,” Health Services and Resources Administration Administrator Thomas Engels said.

Patient advocates and other stakeholders have spent years lobbying for the change, but some officials were hesitant to adopt what could be misconstrued as financial incentives to donate. They didn’t want to be seen as encouraging people to sell their organs, even though donors wouldn’t make any money from their donations.

More than 113,000 people are wait-listed for an organ transplant and someone is added to the list every 10 minutes, according to the Health Resources and Services Administration. Nearly 20 people die every day waiting for a transplant.

HHS has not yet finalized a companion proposal that would standardize how the federal government evaluates organ procurement organizations, or OPOs, by tabulating each organization’s donation and transplant rates using federal death records and then comparing the results.