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. plans to announce on Thursday, according to the agency. 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, officials said.
Mr. Kennedy also plans to demand 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.
“These are huge steps forward, and I think they mark a clear commitment to the public that we are rebuilding trust, and we want people to feel safe when they are making the decision to donate their organs,” Dr. Raymond Lynch, the organ transplant division chief within the U.S. Department of Health and Human Services, said in an interview ahead of the announcement.
Dr. Lynch and other officials pointed to a yearslong history of problems at the South Florida organization, which has been cited by the transplant system’s oversight committee 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 an appeal is denied, the contract will be awarded to another procurement organization.
The South Florida organization did not respond to requests for comment.
Many of the problems in the system stem from an increasingly common practice known as 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, the hospitals caring for the 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 on his breathing tube, according to two Life Alliance employees. The man died, and surgeons removed his organs. 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 are not as sick and haven’t been waiting 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, has been documented in cases involving Life Alliance Organ Recovery Agency. The group’s former executive director told The Times that he disliked skipping 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 in the transplant system. The Department of Health and Human Services once threatened not to renew a contract with a procurement organization — in New York City in 2018 — but ultimately didn’t cut ties.
Congress has pushed to reform the system since 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 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 with health department officials in July and followed up last week with a bipartisan request to the agency for more information about patient safety.
The agency imposed a corrective action plan on the Kentucky procurement organization and has announced a wave of broader changes, including working groups that are writing new policies for circulatory death donation and organ allocation. It is also investigating other procurement organizations.
Mr. Kennedy will announce on Thursday that a crackdown this year on line-skipping has helped direct organs to an estimated 289 patients who otherwise would have been bypassed, officials said.
In a statement, Mr. Kennedy said that the job of the procurement organization “is to honor the gift of life by ensuring trained professionals recover every organ safely, match it fairly, and deliver it quickly to the patient who needs it most.”