OPTN Board recommends fee increase and approves transfer of reserve funds, extension of current pause on routine surveys of OPOs and transplant hospitals, and projects for public comment
Published on: Thursday, August 28, 2025
On August 21, the Board of Directors of the Organ Procurement and Transplantation Network (OPTN) convened virtually for its monthly meeting. During this meeting, the Board voted on a recommendation to increase the OPTN membership fee, authorized the transfer of OPTN reserve funds, approved policy project proposals to be released for public comment, and approved an extension of the current pause on routine surveys of organ procurement organizations (OPOs) and transplant hospitals.
OPTN fee increase
The Board voted to recommend a 19 percent increase of the OPTN fee for Fiscal Year (FY) 2026 (29 approve, 1 reject, 0 abstain) to $1,035.38. Since then, HRSA approved this increase and modified it to $1,036 for administrative ease. This increase will support OPTN operational expenses, including expenses associated with Secretarial and HRSA directives or other OPTN initiatives and priority activities that were not included in the FY26 budget that the previous Board approved at the June 2025 OPTN Board of Directors meeting.
Transfer of OPTN reserves
The Board voted to authorize the release of all funds from the OPTN reserve account(s), currently managed by UNOS, to the OPTN primary account (29 approve, 2 reject, 0 abstain). This transfer is crucial for the smooth operations of the OPTN under contract with UNOS as the operations contractor. While the operations contractor spends down the existing OPTN reserves on approved OPTN expenditures, HRSA will start collecting the new OPTN fees into a single OPTN account, which will include a reserve/contingency fund component.
Extension of pause on routine surveys
The Board approved an extension of the pause on routine surveys of OPOs and transplant hospitals (24 approve, 1 reject, 0 abstain). The pause was originally approved by the previous Board during the June 2025 meeting and will now continue through the first six months of FY26. The OPTN and HRSA will continue to work together to determine the appropriate mechanism and frequency for the surveys in the future.
Policy projects for public comment
The Board approved the following policy projects to be released for public comment:
| Project Name | Committee | Vote Results |
|---|---|---|
| 2025 Histocompatibility HLA Table Update | Histocompatibility Committee | 28 approve, 2 reject, 1 abstain |
| Update and Improve Efficiency in Living Donor Data Collection | Living Donor Committee | 30 approve, 1 reject, 0 abstain |
| Modify Guidance for Pediatric Heart Exception Requests to Address Temporary Mechanical Circulatory Support Equipment Shortage | Heart Transplantation Committee | 29 approve, 1 reject, 1 abstain |
| Require West Nile Virus Seasonal Testing for all Donors | Disease Transmission Advisory Committee | 29 approve, 1 reject, 0 abstain |
| Establish Comprehensive Multi-Organ Allocation Policy | Multi-Organ Transplantation Committee | 25 approve, 6 reject, 0 abstain |
| Require Patient Notification for Waitlist Status Changes | Transplant Coordinators Committee | 29 approve, 0 reject, 0 abstain |
Discussion items
The Board also heard and discussed status updates on allocation out of sequence and updates to the summaries of evidence for SARS-CoV-2 and Mpox, which were previously approved by the Executive Committee at its meeting on August 15.