Kennedy Announces Firing of Organ Transplant Group After Safety Problems

Federal officials will for the first time fire one of the organizations responsible for coordinating organ donations in the United States, Health Secretary Robert F. Kennedy Jr. announced on Thursday. It is an escalation in the government’s efforts to fix the national transplant system after reports of unsafe and unfair practices.

The organization, Life Alliance Organ Recovery Agency in South Florida, is one of 55 nonprofits across the country that have federal contracts to arrange transplants. The decision to cut ties with the organization, effectively shutting it down, is meant to warn the other groups to improve or face a similar fate, Mr. Kennedy said.

Mr. Kennedy also demanded that the groups, known as organ procurement organizations, make changes including appointing patient safety officers to help protect donors and ensure fairness in the allocation of organs.

The moves come after reporting in The New York Times uncovered problems across the transplant system.

“We are taking bold action and historic action to restore trust in the organ procurement process,” Mr. Kennedy said.

He pointed to a “long record of deficiencies directly tied to patient harms” at the South Florida organization, which has been cited for issues including understaffing, poor training and paperwork errors.

The organization, based at the University of Miami, can appeal the decision with the health department and would continue to operate in the interim. If the group loses the contract, it will be awarded to another procurement organization.

The South Florida organization did not respond to requests for comment.

Many problems in the system stem from an increasingly common practice called donation after circulatory death.

While most donated organs come from people who have been declared brain-dead, in these cases the potential donors still have brain function. But they are on life support, often in a coma, and are not expected to recover. If donation is authorized, doctors withdraw life support, wait for the patient’s heart to stop and then remove the organs.

The Times reported in July on a dozen such patients who had endured premature or bungled attempts to retrieve their organs. In some cases, hospitals, which are responsible for caring for potential donors, mistakenly determined that they would not recover. And some procurement organizations ignored signs of alertness in patients being prepared for donation.

One of these cases involved the Miami organization. In 2023, doctors at a Florida hospital withdrew life support from a patient although he was crying and biting his breathing tube, according to two Life Alliance employees. The man died, and his organs were removed. The procurement organization declined to comment on that case, citing privacy laws.

The Association of Organ Procurement Organizations, a national trade group, has emphasized that errors are rare and that donations save thousands of lives every year.

In violation of federal regulations, procurement organizations have also increasingly bypassed patients on transplant waiting lists and given organs to recipients who were not as sick and hadn’t waited as long. The Times has reported that nationwide, the organizations skipped patients in nearly 20 percent of transplants last year — six times as often as a few years earlier.

This, too, was documented in cases involving Life Alliance Organ Recovery Agency. The group’s former executive director told The Times that he disliked bypassing patients, but said the practice was efficient and had helped the organization cut costs.

For years, officials did little to address the line-skipping and other problems. The government once threatened not to renew a contract with a procurement organization — in New York City in 2018 — but ultimately didn’t cut ties. The announcement Thursday is the first time the agency has moved to decertify an organization mid-contract.

The federal government increased oversight of the system after a House committee heard testimony last year about a Kentucky man whose organs were pursued even as he shook his head and drew his knees to his chest. A federal investigation later found that the Kentucky procurement organization had similarly ignored signs of brain activity in dozens of other patients being readied for circulatory death donation.

The House committee held a hearing in July and followed up last week with a bipartisan request to the agency for more information about patient safety. Another committee wrote a separate letter raising concerns about Life Alliance.

The health department ordered the Kentucky procurement organization to make reforms and has announced broader changes. Working groups are writing new policies for circulatory death donation and organ allocation, a public website tracks how often organizations skip patients, and officials are investigating other procurement organizations.

Mr. Kennedy announced on Thursday that a crackdown this year on line-skipping had helped direct organs to an estimated 289 patients who otherwise would have been bypassed.

He spoke proudly about a nephew who had donated his organs. The secretary and other officials said the changes were meant to protect the sacred gift of organ donation and preserve families’ trust.

“If families lose trust, fewer will choose donation,” said Thomas J. Engels, head of the division overseeing the transplant system. “That is simply unacceptable, and we are here to fix it.”