Former HHS head Azar: Innovation, collaboration needed to combat organ scarcity
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Key takeaways:
- The future of the nephology field leans on collaboration between stakeholders.
- Innovation in kidney care may be boosted by rethinking approaches.
PHILADELPHIA — Innovation and collaboration in nephrology may help combat organ scarcity and improve care, former HHS Secretary, the Honorable Alex M. Azar II, said at the American Transplant Congress.
In the Paul I. Terasaki State-of-the-Art Lecture panel series, Azar shared a personal story about his father having chronic kidney disease that progressed to end-stage renal disease, which, in part, ignited Azar’s passion and commitment to transplantation and the patients who rely on the procedure.
Innovation in kidney care
Highlighting the role of innovation in the standard of care, Azar pointed to the KidneyX initiative, launched during his tenure under the Trump administration, as a driver in creating new technologies and alternative transplantable organs. He also advocated for a model like Operation Warp Speed, which he led during the COVID-19 pandemic under President Trump, that used funding to overcome market failures.
“I would frankly like to see a lot more of that, the way we did Operation Warp Speed: use money to solve market failure issues or create incentives for innovation,” Azar said.
The use of 3-D printing could also be an alternative to solve transplant scarcity issues.
“I am on the medical advisory board for 3D Systems ... and we are literally working to print organs that could then basically be the exoskeleton and the stem cells. It is rather remarkable that one could even be thinking of that concept,” Azar said. “Through that, I've gotten to ... see the technologies around the catheter cleansing of kidneys, [as well as] ... a pathogen-free facility in Virginia that was just set up to raise the genetically modified pigs.”
From “everything I'm seeing,” he added, “maybe in the next decade when we're at this meeting, we'll be talking about improving technologies on hopefully an endless supply of organs for individuals, not focusing as we are so often on scarcity issues.”
Addressing transplant scarcity
When it comes to organ scarcity, Azar said payment structures may impact innovation, citing ongoing reforms to the Organ Procurement Organizations and a critical need to set metrics that incentivize both procurement and transplantation.
At what point does the insurer “get in the way, hinder [or] backdoor regulate by deciding not to pay for novel procedures in transplantation?” he asked. “If you set a metric that says that you are rewarded for procuring an organ, then you will get a lot of procured organs. If you set a metric that says you get rewarded for procuring organs that are actually transplanted, then you will get more organs that are procured and transplanted.”
Making it even more practical, he said, “If I am one of the 20 people who's going to die today because there is no organ available for me — you know, a not-perfect organ might make me quite happy ... I think we need to, when we are talking about new technologies, we have to have a similar kind of mindset ... of what advances can we make that may not be perfect but move the ball when the patient is at need.”
Looking toward the future, Azar said he is optimistic about the industry, and underscored the significance of working together.
“There is such a revolution coming out of these kidney care models that I created as secretary,” Azar said. “I just know [of] the people involved, the commitment is there if we can make sure that we have the money available and all work together on clinical trials ... that these innovations can happen in the right frameworks.”
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Azar AM, et al. Paul I. Terasaki state-of-the-art lecture: A fireside chat with the Honorable Alex M. Azar II. Presented at: American Transplant Congress; June 1-5, 2024; Philadelphia.
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