Modernizing the national transplant database

The Organ Donation and Transplantation Network (OPTN) will soon undergo a historic transformation to modernize the national organ transplant system. For the first time in 40 years, the OPTN contract will transition from 1 vendor to 5 to improve transparency, strengthen patient-centered communication, improve patient safety, better manage finances, and upgrade information technology (IT) for organ transplantation. This will be a remarkable change with bipartisan Congressional support. However, the Health Resources and Services Administration, which oversees OPTN, has recognized the complexity of updating the OPTN IT system. On January 17, 2025, it requested submissions for a multiple-award blanket purchase agreement called OPTN Next-Generation IT to help with modernization to improve the OPTN database for patient care and research. This perspective piece reviews the strengths and weaknesses of the current OPTN database using heart transplantation as an example and provides a blueprint to achieve the goals of a flexible database, more comprehensive data collection with clear definitions, and necessary changes to improve efficiency. It also reviews the involvement of the Health Resources and Services Administration and Congress in improving the OPTN, and of sharing OPTN data with the Scientific Registry of Transplant Recipients to generate Scientific Registry of Transplant Recipients national and program reports as well as research.