It is an honor to begin my term as President of the AST. I am grateful for the trust you've placed in me, and I am eager to build on the incredible work of my predecessor, Dr. Jon Kobashigawa, whose leadership has moved the Society forward in meaningful ways. I would also like to extend congratulations to our new President-Elect, Dr. Nicole Turgeon; our newly elected Secretary, Dr. Jesse Schold; and our new Councilors-at-Large: Drs. Christopher Blosser, Lara Danziger-Isakov, and Helen Te. Your expertise and dedication will be essential in the months ahead.
I’ve been a proud member of the AST for nearly 25 years. Over that time, I’ve had the privilege of serving on the Board of Directors and contributing to numerous committees and work groups. These experiences have connected me with AST colleagues who are passionate, collaborative, and forward-thinking. We all want to improve the field of transplantation and, most importantly, the lives of our patients.
We are entering a pivotal moment in transplantation. As you know, we are undergoing a significant transformation in our national transplant system through OPTN modernization. After four decades of operation under a single contractor, we are now transitioning to a model with multiple contractors—a change that has brought understandable uncertainty, concern, and heightened attention to the role of governmental oversight.
Despite the challenges, this moment also brings opportunity. We have a critical window to work collaboratively with government agencies, Congress, and other stakeholders to ensure the modernized system serves donors, recipients, families, and professionals more effectively. Over the past year, we have met on multiple occasions with members of HRSA, HHS, the Government Accountability Office, and congressional leaders to discuss the process of OPTN modernization and strategies to improve the current system. Our society will remain fully engaged throughout the next year, and we will continue to advocate frequently and forcefully on behalf of our members and the patients we serve.
In the coming year, we will also launch and support several high-priority initiatives, including:
Patient-Centered Advocacy and Innovation
Building on the recent AST survey of over 10,000 transplant recipients—the largest of its kind—we will work to elevate patient voices in public policy discussions. This data will help us advocate for the development of new therapies to reduce the significant side effects of lifelong immunosuppression. We also intend to use the insights gained in the survey to bolster our patient advocacy efforts with both federal agencies and Congress.
Strengthening OPO-Transplant Center Collaboration
In collaboration with key stakeholders, we will design educational symposia focused on improving alignment, communication, and collaboration between Organ Procurement Organizations (OPOs) and transplant centers—two vital parts of our interconnected system. Getting there will require a dual understanding of the challenges that OPOs and transplant centers face within the confines of our organ allocation system. We must be sure that our goals are aligned, and our practices support the best interests of donors and their families as well as transplant recipients in need of life-saving organ transplants. We are the transplant experts who should shape the processes and policies needed to make the system more efficient. We will work together to do just that for the betterment of our patients.
Public Perception and Professional Standards
Recent media portrayals of our system have painted donor and transplant practices in ways that are often unbalanced and lack necessary context. While we acknowledge the need for improvement, transparency, and accountability, we also recognize the importance of accurate representation. We will work with all stakeholders and governmental agencies to define and promote best practices across the transplant system, while simultaneously launching public education efforts that reflect the extraordinary work and dedication of our transplant community.
Clinical Practice Guidelines Infrastructure
Our society needs a pathway for the development of meaningful clinical practice guidelines in transplantation. We will continue to build the infrastructure needed to support the development of clinical practice guidelines—something long overdue in our field. The AST will lead the community in these efforts so that the guidelines will provide the foundation for high-quality, consistent care across transplant programs and patient populations.
Educational Expansion on Emerging Innovations
Our members must be equipped to understand and lead the adoption of cutting-edge innovations. We will expand our educational programming to include recent developments in topics such as ex vivo machine perfusion, normothermic regional perfusion, xenotransplantation, and artificial intelligence as it evolves within the transplant ecosystem.
Strengthening Our Workforce
A sustainable transplant workforce is essential to our field’s future, but we face real challenges in attracting and retaining trainees. Based on the work of our AST Fellows Task Force and its recent AJT publication, our society remains committed to tackling this issue directly through targeted outreach, mentorship, and pipeline-building initiatives aligned with our strategic aim of workforce development. We will continue to support travel grants for our trainees to attend the Fellows Symposium and the American Transplant Congress so that they get excited about the amazing field in which we all practice. Together, we will continue to inspire and support the next generation of transplant professionals.
Addressing Barriers to Living Donation
The AST will remain committed to addressing barriers to living donation through the Living Donor Circle of Excellence Program and other focused advocacy efforts. Our Living Donor Task Force has a renewed focus on identifying strategies aimed at ensuring that willing donors are supported, protected, and empowered to give the gift of life.
I look forward to working alongside each of you in the year ahead and to building a future for transplantation that is more innovative, equitable, and patient-centered. The strength of our society lies within its membership, a membership that is informed and engaged. Whether you’re a clinician, researcher, patient advocate, or industry partner, your voice matters — and I want to hear from you.
I believe in a leadership style rooted in service — one that empowers others, fosters creativity, and unites us around a shared vision. I am proud to represent you and grateful to be part of a Society that continues to lead with purpose, passion, and a deep commitment to improving patient care.
Thank you for the opportunity to serve as your President.
David Foley, MD
AST President
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