Background

U.S. transplant programs are evaluated by the OPTN on several key metrics developed by the Scientific Registry for Transplant Recipients (SRTR). These metrics include:

• How often a transplanted organ is still functioning 90 days and one year after transplant
• Patient deaths while waiting for a transplant per time waiting on the list
• How often a transplant program accepts an organ offer compared to the number of offers they could have accepted and transplanted

What’s new in UNOS Predict 2.0

UNOS researchers and data analysts work to develop enhancements to Predict to better support transplants programs. Predict 2.0 launched in early 2026 including:

• Access to individual patient-level data for post-transplant survival and pre-transplant mortality
• Offer acceptance ratios for heart and kidney
• “What if” simulator to explore how different patient scenarios can affect program performance

Why this matters

Shaped by user feedback, these enhancements allow transplant programs to identify trends in their data, prepare for potential challenges, advocate for additional resources, and make informed, data-driven decisions to drive continuous improvement to help save and transform more lives.

Looking ahead

“Predict provides our transplant programs with the essential forward-looking view we need, moving beyond the rearview mirror. It delivers crucial risk-adjusted results, empowering the transplant teams to respond proactively and grow effectively. This allows us to appropriately expand our program’s reach and ultimately, helps us to serve more patients and families.”

— Colleen O’Donnell Flores, MHA, Director of Transplant Quality & Regulatory Affairs, Northwell Health Transplant Institute

UNOS is committed to continuing to improve UNOS Predict, and the team is continuing to review feedback from the community. Feedback and questions can be submitted to [email protected].

When Abbey Olsen, transplant quality manager at University of Utah Health, entered the transplant field five years ago, she recalls how overwhelming it was to navigate numerous data sources. Despite her clinical background as a nurse, she initially found the complex data difficult to interpret. Once she started using UNOS Tools, her outlook changed.

“One of the difficult things that we encounter in an environment where there’s a lot of data is trying to connect the data with purpose,” she says. “These dashboards that UNOS has created really help connect those dots so we can make actionable decisions.”

Supporting confident decisions in real time

She points to the University of Utah Health’s lung transplant program, which has grown over the past few years, partially thanks to the insights gained from examining its acceptance practices using the UNOS CARE Tool and organ outcome report. 

“It allows our providers to review their decision-making, gain confidence and then possibly expand their tolerance for risk,” she says. 

Olsen says the weekly updates to the Key Insight Dashboard enable her to track her team’s performance in real time and compare it to the same period in previous years to make sure they are on track. 

She highlights the recent improvements to UNOS Benchmark reports, which now refresh monthly instead of quarterly and allow centers to easily adjust comparison groups. This flexibility helps her team evaluate how their outcomes compare to similar programs, identify areas for improvement and model future growth by benchmarking against aspirational centers.

She says the tool’s real-time, multipurpose functionality makes it far more useful and responsive than earlier versions. Overall, the Benchmark Report “has definitely helped us expand our donor criteria and transplant more patients,” she says.

Faster insights, less manual work

Olsen estimates that UNOS Tools save her more than 20 hours of work per month. “It takes out that manual process and automates it so we’re able to utilize our time better,” she says. “We’re able to make decisions faster and then it saves time on our part for preparation [for meetings.]”

“The good thing with … these dashboards is that you don’t have to create your own visualizations to get the story through to your decision makers,” she says. “We’re able to identify trends and then we can readily share that information in a way that is easily digestible and actionable.

“UNOS has provided us with an amazing framework and foundation as they continue to evolve these tools. I would be at a loss [without them.]”

In early 2025, The Ohio State University Wexner Medical Center’s kidney surgeons voiced concern they were not receiving as many organ offers. Using the UNOS CARE Tool, Molly Maxwell, nurse manager of the abdominal transplant team, was able to quickly uncover the truth: Offers had not declined, but acceptances had.

The CARE Tool let Maxwell drill down on different variables to see surgeons were more likely to turn down kidneys that came from more than 250 miles away and that were greater than 100 in the offer sequence. The team looked at outcomes when these organs were transplanted elsewhere and realized they were declining some organs that did well in other patients.

Changing acceptance behaviors “has made a huge – I mean huge – difference,” she says. “You can see our transplant volume increased pretty significantly from that point on.”

She says the CARE Tools system map is “amazing” and allowed her to show that only  about 10% of Wexner’s kidneys came from more than 250 miles away, while comparable programs were accepting a higher percentage or organs coming from a similar distance.

The realization led the team to rethink transportation. Because the local airport in Columbus, Ohio, is not open 24-hours, they now consider other options. “Can we fly into Cleveland or Cincinnati and drive it?” she says.

Maxwell also uses the CARE Tool with heart and lung teams to look at declined organs that later resulted in successful transplants elsewhere. She says often, surgeons decline lungs based on their scans. Digging into these decisions with the CARE Tool, “helps validate some of the decisions,” she says, “but it also helps you see what you need to focus on.”

For Maxwell, the CARE Tool is essential for helping her teams understand offer patterns, identify missed opportunities and accept more organs for transplant. “I don’t know that we would be able to monitor offer acceptance at all without this tool,” she says.

About the research

UNOS conducted an online survey to assess the public’s attitude toward xenotransplantation to measure public support and identify personal characteristics associated with acceptance. Over 1,400 adults participated between April 8 – July 8, 2024. People belonging to religious and racial minority groups were intentionally included in higher numbers so the results would more appropriately reflect the U.S. population.

UNOS received grant funding from Sanofi to conduct research about xenotransplantation. UNOS continues to conduct research on xenotransplantation as part of its mission.

What is porcine xenotransplantation?

Transplanting genetically modified pig organs into humans.

Key findings

Nearly 9/10 respondents support porcine xenotransplantation

Support varies by race, religion, political affiliation, and a person’s experience with transplantation

Black and Muslim respondents were less supportive of xenotransplantation compared to other groups

Over 60% shared concerns of patient safety or animal-derived disease transmission

Support for Xenotransplantation

Support using porcine organs

Would accept for self with similar risks and benefits

Would accept for loved one with similar risks and benefits

Why this matters

Xenotransplantation could shorten the waitlist by making more organs available for transplant. Understanding the public’s beliefs and concerns will help guide how the transplant community and the public are educated on xenotransplantation to ensure everyone has access to clear, accurate information.

What’s next

UNOS is assessing providers’ and transplant administrators’ attitudes towards xenotransplantation.

About UNOS research

UNOS conducts research as part of its mission to save and transform lives through research, innovation and collaboration.