The U.S. organ transplant system is failing patients due to outdated technology and inefficiencies. With scalable, standards-driven solutions, we have a real opportunity to build a faster, fairer, and more transparent network that saves lives.
The U.S. organ transplant system is under intense national scrutiny. A recent article in The New York Times shared the stories of people suffering from systemic failures in the allocation of lifesaving organs.
At fifteen years old, Marcus Edsall-Parr had already been waiting for a kidney transplant for nearly a decade. When a perfect match became available last spring, his doctors were hopeful—it was the best opportunity he had seen in years. But Marcus never received the kidney. Instead of following the national transplant waiting list, the organ was allocated elsewhere, leaving Marcus and his family devastated. His story is not unique. Across the U.S., critically ill patients are being bypassed in favor of recipients chosen through opaque, inconsistent processes.
In part, this is a story of outdated technology (but also ethics, governance, contracting). Like many critical organizations, the Organ Procurement and Transplantation Network (OPTN) operates on an aging IT backbone that is decades old (e.g., late 90s, SQL, on prem).
At Leap Orbit, we are part of the growing chorus that believes modernizing the technology behind the transplant system isn’t just an upgrade— it’s a necessity to adapt to the evolving needs of medicine, policy, and patient care.
The OPTN plays a central role in the U.S. organ transplant system, overseeing the national transplant waiting list and facilitating organ matching and allocation. However, it operates within a broader ecosystem involving multiple key organizations:
Collectively, these organizations work in tandem to manage and regulate the complex process of organ donation and transplantation in the United States.
The federal government has recognized the dire state of the transplant network. A 2021 report from the U.S. Digital Service (USDS) titled Lives Are At Stake: The Government’s Role in Modernizing the OPTN called out the IT infrastructure’s deep flaws. The software that powers UNet—the system that matches organ donors with recipients—has become a bottleneck, preventing much-needed process improvements.
The core issues include:
These inefficiencies have real consequences: Controlling for external factors such as the opioid epidemic, we are doing no better at getting organs to patients than we were a decade ago.
The challenges facing OPTN are not unique. Across industries, we see outdated systems burdened by technical debt and rigid infrastructures. The key to modernization is not a costly, time-consuming custom rebuild—it’s leveraging commercial off-the-shelf (COTS) platforms, open standards, and modular microservices to incrementally replace legacy systems with modern, scalable solutions.
At Leap Orbit, we have deep expertise in health IT modernization, federal healthcare projects, and scalable data platforms. Our proposed approach for modernization includes three core principles:
Instead of building a proprietary system from scratch, HRSA should adopt COTS solutions—pre-built, configurable platforms that are already cloud-based, user-editable, and AI-enhanced. This reduces development timelines dramatically and ensures that future updates can be made without costly overhauls.
Healthcare needs the humility to recognize that in many cases, industry-agnostic enterprise platforms have solved many of the same workflow challenges – and should be adopted. Customization should only be done around the edges of a robust data platform.
A Next-Gen OPTN must be built on Fast Healthcare Interoperability Resources (FHIR) APIs, United States Core Data for Interoperability (USCDI) for data content, and Trusted Exchange Framework and Common Agreement (TEFCA) for trust frameworks. These standards ensure future-proofed integration with other healthcare data systems and reduce the custom work required by transplant centers, OPOs, and hospitals.
The new solution should be developed as a series of microservices—small, independent components that can replace individual workflows within UNet without disrupting the entire system. Using an agile, iterative delivery model, HRSA can incrementally roll out improvements, replacing one outdated function at a time while maintaining uninterrupted operations.
Modernization isn’t just about technology; it’s about restoring faith in the system. Patients, providers, and policymakers need real-time visibility into organ allocation processes. We are fierce advocates for radical transparency in system development:
Marcus’s story is just one of many that illustrate why modernization is not an abstract policy discussion—it’s a matter of life and death. No patient should have to experience the heartbreak of losing a perfectly matched organ due to inefficiencies in an outdated system.
The good news? Leap Orbit recommends embracing COTS platforms, open standards, and a microservices-based architecture to help HRSA build a transplant network that is faster, fairer, and future-proof—and, most importantly, one that ensures every donated organ has the best chance of saving a life.
At Leap Orbit, we don’t just modernize software—we modernize health systems. Interested in learning more? Connect with us at inspired@leaporbit.com.