United Network for Organ Sharing FAQs

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• What is the technology that operates the match runs?
• What is UNOS’ role in living donation?
• Who are our members?
• What is the role of CMS and UNOS in transplant hospital and OPO oversight?
• What falls outside of UNOS’ purview?

Is UNOS a government agency?

No. UNOS is a nonprofit organization with decades of experience in helping save lives through research, technology, innovation and education, including through its management of the nation’s Organ Procurement and Transplantation Network (OPTN) under contract with the federal government.

What is the OPTN? 

The Organ Procurement and Transplantation Network is the name of the transplant system in the United States. It’s a unique public-private partnership that links all professionals involved in the U.S. donation and transplantation system. The OPTN brings together medical professionals, transplant recipients, donor families, and representatives from transplant associations to develop organ transplantation policy. UNOS manages the OPTN under contract with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS).

How are organ allocation policies created? 

The OPTN acts through its board of directors and committees, experts from the donation and transplantation community and general public representatives (organ recipients, organ donor families, living donors). Committees address issues of concern in the transplant community and develop evidence-based policies for board review and approval. The board establishes and maintains transplant policies (operational rules) and bylaws (membership requirements) that govern the OPTN. 

What is UNOS’ role in donation and transplant?

In its role as the OPTN contractor, UNOS manages how patients get matched with available organs, in compliance with allocation policies developed by the community and approved by the OPTN board of directors.  UNOS also works with and for the donation and transplant community to improve the resources and support we offer.

UNOS, in its role as the OPTN contractor, provides the forum for organ donation and transplant professionals to come together and determine how the national system should work, with focus in three key areas:

• Promoting equitable access to available organs (making sure that all people listed for a transplant have similar chances to receive an organ)
• Maximizing organ utilization (making sure that as many donated organs as possible are used)
• Increasing transplant system efficiency (improving the processes involved in the placement of organs)

In addition to its work with the OPTN, UNOS runs a privately funded virtual research center, UNOS LabsSM. UNOS has invested more than $1M to support this initiative through research, innovation and collaboration with the transplant and broader scientific communities.

Does UNOS register patients for transplants? 

Only transplant hospitals can register patients on the waiting list for transplant or remove them from the list.  

What is the technology that operates the match runs?

UNet^SM  is the centralized computer network, developed by UNOS, that links all organ procurement organizations, transplant hospitals and histocompatibility labs. Thousands of transplant professionals access this secure web-based transplant platform each day to list patients for transplant, match patients with available donor organs and submit required OPTN data.

What is the OPTN’s role in living donation?

In 2023, more than 6,900 people became living donors. The OPTN Living Donor Committee develops policy and guidance supporting the donation and transplantation of organs from living donors to recipients. The committee’s goal is to continue to improve the informed choice of prospective living donors and increase the number of organs available for transplant.

Who are our members?

Every transplant hospital program, organ procurement organization, and transplant histocompatibility laboratory in the U.S. is a member. Membership means that an institution meets OPTN requirements and that it plays an active role in forming the policies that govern the transplant community.

Other OPTN members include voluntary health organizations, such as the National Kidney Foundation; general public members, such as ethicists and donor family members; and medical professional/scientific organizations, such as the American Society of Transplantation.

Individuals from member organizations participate in the decision-making process through representation on committees and on the board of directors.

What is the role of CMS and UNOS in transplant hospital and OPO oversight?

There are three steps in oversight. As the OPTN manager, UNOS manages the first two – self reporting and peer review. UNOS provides data reports, tools and coaching to help members improve and avoid the third step, which is regulatory. Centers for Medicare & Medicaid Services (CMS) provides regulatory oversight.

What falls outside of UNOS’ purview as OPTN contractor? 

UNOS does not oversee member finances, determination of death, or decisions about what patients are listed or removed from the waiting list for transplantation.