Writing · topic · 9 articles
The OrganWatch investigation into US organ procurement, the tissue trade, and consent — the organ-system accountability project, not general healthcare policy.
The US organ-procurement, transplant, and tissue system, assembled from government records: hundreds of source-linked findings on a federally protected monopoly, the procurement-vs-care conflict at the bedside, the consent gaps over unclaimed bodies, the money, the prosecutions, and the sworn testimony. The index to the whole OrganWatch investigation. Institution level, zero personal data.
Organ and tissue industry · Health and medicine · Transparency and open data
For the first time, the US government grades every organ procurement organization on objective outcome measures and publishes the result. The tiers are damning: roughly a third of OPOs sit in the lowest band, which CMS itself deems out of compliance and eligible for decertification. A sourced reading of the CMS tier data — what the tiers mean, which OPOs are in Tier 3, and how the first-ever decertification finally happened.
Health and medicine · Organ and tissue industry · Transparency and open data
The consent gaps in US body donation exist because there is a paying market on the other side. A sourced account of the demand side: medical-device companies that run cadaver labs, the US military buying donated bodies for blast and landmine testing, surgical-training firms, and the per-part price market that moved tens of thousands of bodies — all lawful, because federal law bars selling organs for transplant but barely touches the non-transplant body trade.
Health and medicine · Organ and tissue industry · Transparency and open data
The consent gaps in US body and tissue donation are not theoretical — they have a criminal record. A sourced account of the court cases: a $58.5M verdict against an Arizona body-donation company, federal prison for operators who sold bodies with forged consent, convictions for shipping disease-infected tissue, and the 2025 Harvard Medical School morgue trafficking case — set against the law that bans selling transplant organs but barely touches the non-transplant body trade.
Health and medicine · Organ and tissue industry · Transparency and open data
If you died unclaimed, could your body be sent for dissection or research without consent? The answer depends almost entirely on the state. Reading the statutes for all 51 US jurisdictions finds that 33 permit use of an unclaimed or indigent body without affirmative next-of-kin consent, and only 13 require consent. A sourced, de-identified map of the 50-state patchwork.
Health and medicine · Organ and tissue industry · Transparency and open data
The hardest question in the US organ system is at the bedside of the dying: when does recovery begin, and who is watching for the patient rather than the organ? In 2025 a federal HRSA review of 351 donation-after-circulatory-death cases found concerning features in roughly 29% and concluded a number of patients may not have been deceased when procurement began. A sourced, de-identified account of the dead-donor rule, the NRP controversy, the premature-procurement findings, and the structural conflict behind them.
Health and medicine · Organ and tissue industry · Transparency and open data
Organ donation is free; the system around it is not. The federally designated OPOs are cost-reimbursed regional monopolies, and the largest are nonprofits reporting $100M+ revenue with seven-figure executive pay. A sourced follow-the-money account — the cost-plus model, the OPTN contract, the Senate Finance finding that OPOs have stronger incentives for tissue than for lifesaving organs, the for-profit tissue pipeline, lobbying against reform, and the federal audits. Institution/role level, zero personal data.
Health and medicine · Organ and tissue industry · Transparency and open data
When a person dies unclaimed or indigent in America, the law in most states lets their body be sent for dissection, research, or the for-profit body trade with no next-of-kin consent required. A sourced account of the consent gap — the state unclaimed-body statutes, the documented University of North Texas case, the coroner cornea-removal laws and the court split over whether a body is property, and the FDA exemption that leaves whole bodies and tissue barely regulated while transplant organs are tightly governed.
Health and medicine · Organ and tissue industry · Transparency and open data
The US organ-procurement system is a federally regulated monopoly — 56+ Organ Procurement Organizations with exclusive territories feeding a national network that had one contractor for nearly four decades. Its failures are documented by the government itself: a CMS performance rule, a bipartisan Senate Finance investigation, HRSA’s breakup of the monopoly, GAO and HHS-OIG audits, and in 2025 the first move to decertify an OPO. Sourced, with the public data behind it.
Health and medicine · Organ and tissue industry · Transparency and open data
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