WASHINGTON—The good news came on Heather Knuckles’s wedding day: Her mother, bedridden with a failing liver and kidneys, had an organ match.

It was the happiest day of their lives, Knuckles said, recalling her mother smiling while picturing a new life in front of her.

Instead, she said, what began was a nightmare.

Knuckles’s mother, Mary Ann Hollis, underwent liver and kidney transplants on Oct. 30, 2022. Five days after the surgery, doctors told the family that the donor liver had a previously unreported issue: a rare and deadly form of cancer.

Hollis soon had a second surgery to replace the liver, a four-hour procedure that left her fragile and in delirium.

By Christmas, she was on a feeding tube, and family members crowded at her bedside to open gifts she was too weak to open by herself. She died three weeks later, with a solid mass developing in her body.

What killed her was the cancer—undifferentiated adenocarcinoma—from the donor whose organs Knuckles said should have never been eligible for transplant in the first place.

Three years later, amid new national scrutiny of the U.S. organ transplant system and its procurement process, she is now demanding accountability.

“No one should ever have to experience what my mother and our family has endured,” she told lawmakers at a Dec. 2 congressional hearing amid the ongoing inquiry into the nonprofits facilitating organ donations and transplants known as Organ Procurement Organizations (OPO).

And her story was far from an outlier.

‘Inhumane’

At the hearing, whistleblowers testified to having seen donor organs discarded, concerns of potential malpractice silenced, and patients on the brink of having their organs removed even though they showed clear signs of life.

One witness is Nyckoletta Martin, a former surgical preservation coordinator with Kentucky Organ Donor Affiliates, which later merged with another OPO to form the Network for Hope in October 2024.

The hospital in 2021 received TJ Hoover, who was in cardiac arrest and remained unresponsive for days. He woke up in the operating room just as doctors were assessing whether his organs were healthy enough for donation. But instead of immediately halting the procedure, Martin said, medical staff allegedly sedated Hoover to stop his movement, alarming some staffers who called the actions “inhumane” and akin to “human euthanasia.”

Network for Hope is one of 55 OPOs in the United States tasked with recovering organs for transplantation.

A federal probe in July uncovered more than 100 cases in which organ procurement began while patients were still showing signs of life. Following that, the Department of Health and Human Services decertified an organ procurement group, saying that the decertification was a warning to other transplant procurement networks.

Jennifer Erickson, senior fellow for organ donation policy at the Federation of American Scientists, described the United States as having reached national-crisis levels of corruption at OPOs.

“Taxpayer-funded OPOs operate with virtually no accountability, and OPOs have pressured grieving families and, in the most horrifying cases, targeted patients who aren’t even dead,” she told lawmakers.

Whistleblowers have told Erickson that they have been trained to “target inexperienced physicians, especially in rural America,” to worsen patients’ conditions by over-administering comfort medications such as fentanyl, she said.

Rep. Don Beyer (D-Va.) later circled back to this point.

“Isn’t this essentially trying to kill people in order to get their organs?” he asked.

Erickson replied: “I want to be absolutely clear, the things we are talking about are crimes.

“That is not just a danger to the people who live there. It’s a danger to any American who travels through any of these states where whistleblowers have shared [that] these practices happen.”

Charles Bearden, the United States’ longest-serving transplant coordinator, who passed away in the summer, once “literally covered a patient with his own body to stop dangerous OPOs from harming patients who could otherwise survive,” Erickson said.

“The line between organ donation and organ harvesting is consent,“ she said. ”No family would consent to a loved one being wheeled [in] ... to have their organs removed when they could survive. Yet that’s what’s happening across the country.”

Silenced

After what happened to Hoover, Martin said, several staff wanted to report the case to the appropriate authorities. However, they were told that the OPO would deal with the matter internally, she said.

“Our access to TJ’s records was restricted,“ she said. ”We were silenced.”

Martin quit her job over the facility’s handling of the case and was fired by her new employer, Buckeye Transplant, after she spoke publicly about the issue.

Martin said she saw a pattern while reading a letter from the House Ways and Means Subcommittee on Oversight to the New Jersey Organ and Tissue Sharing Network, an OPO that the committee is investigating over Medicare fraud concerns.

More than a dozen whistleblowers have brought forth concerning allegations of directives being given for organ procurement to proceed after a patient showed signs of life and deletion of documentation. The letter further cited Excel sheets from the organization allegedly showing mass discarding of pancreases, collected in the name of research but apparently meant to improve metrics instead, the committee said.

The parallels between her experience and the whistleblower allegations in the letter were “unmistakable,” Martin said, highlighting “systemic failures that demand urgent accountability and reform.”

The United Network for Organ Sharing (UNOS), which manages the national organ waiting list and matching system under federal contract, had threatened legal action against witnesses from a previous House hearing, Erickson said, citing local media reports from Richmond, Virginia, where the organization is based.

The nonprofit, in a Dec. 2 statement, said it “adheres to whistleblower protection laws and does not tolerate, or engage in, retaliation against whistleblowers.”

“UNOS has never engaged in any unlawful behavior,” it stated. “Any statement to the contrary is outrageous and actionable in court.”

In response to a query from The Epoch Times, the network pointed to a July testimony by UNOS CEO Maureen McBride in Congress, in which she suggested creating a “no wrong door” patient safety reporting system to address potential concerns.

The case of Knuckles’s mother is “deeply disturbing,” McBride said, but UNOS does not regulate OPOs or transplant hospitals or participate in clinical decision-making.

Barry Massa, CEO of Network for Hope, said the claims from the hearing “do not reflect the positive impact of Network for Hope since its merger.”

“Network for Hope has worked cooperatively with Congress and oversight agencies,” he told The Epoch Times.

He said his organization is “committed to transparency, accountability, and continuous improvement in the organ donation process,” reiterating its mission to “prioritize and ensure a safe and compassionate donation process for the individuals who are donors and their families.”

For people working at OPOs, Martin said, her advice is “don’t be afraid.”

“We are on the front lines,“ she said. ”We are that patient’s advocate. That’s what we all sign up for, right? We are protected in ways, but at the end of the day, you know, we’re all here to save lives. We can’t let this keep continuing to go on.”