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Improve the process of getting the right organ to the right patient at the right time


Automate real-time donor referral

Establish better metrics

Get the right organ to the right patient

Remove disincentives

Enable OPOs to merge or share services

Save even more lives

The U.S. has the highest performing donation and transplant system in the world. But as good as it is, it needs to get even better to support the more than 100,000 patients on the waiting list. Based on the input of experts in our field, UNOS is proposing a five-part package of reforms to drive improvements to save even more lives.


Available organs sometimes go unused because the unique medical circumstances of the donor limit the number of candidates who could benefit from the organ. The matching system can be made more efficient by directing such organs in a timely way to transplant programs most willing to accept them.

UNOS is developing and implementing a number of innovative projects to increase the efficiency of organ placement, often for organs that may otherwise go unused under the traditional matching system. In these efforts, UNOS draws from data gained from more than 30 years of serving as the OPTN and partnerships with OPOs, transplant hospitals, and leaders in technology, research and science nationwide. Recent and current initiatives include:

Creating the first national donor image sharing hub

UNOS is implementing, in a phased fashion, the first national hub for securely sharing high-quality medical imaging studies. Incorporating quick access to high quality radiological images into organ offers has the potential to decrease the number of organs that are not used and increase the number of transplants overall.

Using organ acceptance data to improve the decision-making process

UNOS has piloted a project to promote efficiency in donation and transplant by providing transplant programs the ability to set more sophisticated screening criteria for offers they will accept. Utilizing these filters reduces unwanted offers, decreases cold ischemic time, and increases organ acceptance, especially of hard to place organs.

Visualizing and evaluating organ acceptance and refusal

Our interactive tool allows transplant centers to review their own organ acceptance rates for specific types of donors, along with transplant-specific and aggregate outcomes information on the organs they refused that were transplanted elsewhere. Centers use the information to analyze and improve their clinical decision-making processes with the goal of increasing transplants.

Providing OPOs quality improvement tools

UNOS makes available benchmark reports for OPOs that allow them to compare their own organ offer placement attempts to their peers and determine how their processes affect their ability to recover and place organs.

Research to optimize system efficiency

Deep understanding to pave the way to increased organ utilization, by:

Simulating organ acceptance to increase the number of transplants

Our powerful simulation platform, SimUNetSM, allows researchers to analyze a variety of factors involved in the organ acceptance process, acting as a testing ground for understanding and improving behaviors.

Deploying natural language processing to increase kidney utilization

A study led by UNOS researchers investigates how this innovative methodology may predict which deceased donor kidneys will experience placement difficulties and forecast which will be accepted by transplant hospitals, and paves the way for improving organ utilization rates.

Predicting organ travel time

To decrease the nationwide organ discard rate, UNOS researchers are involved in a project to better predict organ travel time. Our team is conducting real-time data analysis to refine a feasibility algorithm aimed at predicting the optimal route for organ transplantation.

Understanding the role of biopsies on organ transplant outcomes

UNOS is partnering with university researchers on a study that aims to reduce the national kidney discard rate by clarifying associations between kidney-specific prognostic markers and long-term, post-transplant outcomes.


By adopting policies and practices that streamline organ offers and acceptance, the organ donation and transplant field can improve the matching system and eliminate speedbumps that can keep the organ procurement system from working as efficiently as possible.


UNOS will increase its efforts to implement innovative technology solutions that aim to increase organ utilization and system efficiency.

Originally published on Sept. 15, 2020; updated Dec. 5, 2020

1 million transplants

The U.S. surpassed 1 million transplants in 2022

The gifts of generous donors and their courageous families made several lifesaving transplant records possible.


Insights from UNOS leaders on key issues in transplant today

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Benefits of streamlining organ offers and acceptance

  • Increased utilization of lifesaving organs.
  • Reduction in unwanted organ offers.
  • Improved patient outcomes.

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Remove disincentives

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