Earlier this month as part of a years-long investigation, the Senate Finance Committee held a fiery, bipartisan hearing into fatal failures, corruption and abuses in our national organ donation system.

This has particular significance to our Rio Grande Valley (RGV) communities, which have higher chronic renal, liver, heart, and lung illnesses than in any other part of the country, and, therefore, some of the highest needs for organ transplants. 

Diabetes alone is a chronic condition that affects one-third of our population, which frequently results in chronic kidney disease, and two in five RGV residents suffer from hypertension. That was already the baseline; COVID will throw fuel on the fire. The end result: far too many of our loved ones are likely to develop organ failure.

The best treatment for organ failure, of course, is often an organ transplant. But that is much easier said than done. The U.S. organ donation system is abysmal, leaving 33 Americans to die every day, much of which is entirely unnecessary, with disproportionately worse outcomes for people of color.

The organ donation system is run by a little-know network of government monopoly contractors, called organ procurement organizations (OPOs), whose responsibility is to show up at the hospital in the event of an organ donation eligible deaths, such as traumas or opioid overdoses, and then to counsel the donor’s surviving family to coordinate the organ recovery.

OPOs, however, are grossly mismanaged and entirely unaccountable and more than half of the nation’s 57 OPOs are failing basic performance standards. The system is broken writ large and,  in addition to the Senate Finance Committee investigation and associated hearing, OPOs are under a separate bipartisan House Oversight Committee investigation for severe performance failure; fatal lapses in quality control and patient safety; financial conflicts of interest; and Medicare Fraud, among other abuses. Shockingly, some government estimates show that  OPOs may only be recovering organs from as few as one in five potential donors. 

These investigations are critical to saving lives now in the RGV especially. The OPO that is contracted to service our area, Texas Organ Sharing Network (TOSA), is among the very worst. According to data from the federal government, TOSA was responsible for 264 preventable deaths in 2020 alone, the most recent year for which data is available, with particularly poor service for Hispanic patients – ranking 42nd out of 46 OPOs that should represent our majority ethnicity.

Despite such gross and fatal negligence, TOSA has never faced any regulatory or oversight consequences, while its executives are paid handsomely. And rather than make even the most marginal attempts to improve, OPOs have invested heavily in special interest lobbying campaigns, often characterized by misinformation and obfuscation

For example, OPOs regularly claim credit for recent increases in the absolute number of organ donors, despite research finding that such increases are entirely due to public health crises such as the opioid epidemic, as well as recent spikes in gun deaths and car accidents, which have skyrocketed as second-order effects of the COVID pandemic. This is nothing to celebrate, as one OPO executive was caught on tape doing.

OPOs need to be held accountable. Until then, our friends and neighbors in the RGV will continue to die unnecessarily at excessively high rates. Senator Cornyn needs to hear from all of us. Contact his office to demand the functioning and fair organ procurement system we deserve. Urge him to demand the same from the Biden administration and HHS now to hold OPOs like TOSA accountable by implementing the bipartisan reforms proposed by the Senate Finance Committee. In addition, it is important that candidates of the 15th and 34th congressional district issue statements of support or, more likely, note this issue in their healthcare platforms.

RGV lives are depending on these actions and there is no time to waste.

Editor’s Note: The above guest column was penned by Dr. Sujan Gogu, a triple-board certified physician in family medicine, sports medicine, and pain medicine who is currently working in the Rio Grande Valley at South Texas Health System Clinics. Dr. Gogu’s clinical focus is in an underserved community. He is a graduate from Edward Via College of Osteopathic Medicine in Blacksburg, VA. He completed his family medicine residency at The University of Texas Health Science Center in San Antonio, followed by a sports medicine fellowship at Texas A&M University in Bryan and a pain medicine fellowship at Texas Pain Institute in Fort Worth. Dr. Gogu (pictured above) serves on many boards and is active in many physician and patient advocacy groups, including being co-founder of Doctors in Politics. Originally from San Antonio, Texas, Dr. Gogu now lives in the Rio Grande Valley, with his wife. He can be reached by email via: [email protected]


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