How we develop policy


UNOS follows a collaborative development process for policies that govern the allocation, procurement and transportation of deceased organs. This process encourages participation by the public and all areas of the transplant community. It also promotes equity among patients waiting for organs and allows us to modify policy to reflect current science and medical practice.

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The policy development process

Identify an issue

An OPTN committee develops possible solutions to issues identified using data analysis provided by UNOS and/or SRTR research staff and other supporting information.

Investigate options and draft a proposal

After considering multiple solutions, committee members build consensus among their peers and draft language of a policy proposal.

Request and receive feedback

The committee prepares and distributes an initial public comment document including the rationale surrounding the proposed policies. This proposal language is made available on the Organ Procurement and Transplantation Network website so both transplant professionals and members of the general public can read it and give the committee their unique perspectives.

Rework the proposal (as needed)

The committee reviews public comments on the proposed policies and makes any appropriate changes to the proposal. Sometimes, feedback collected during the public comment period results in the proposal language being revised or rewritten entirely before being sent to the OPTN Board of Directors for a vote. If significant changes are made, the revised language goes out for public comment a second time.

Board of directors votes

The OPTN Board of Directors meets twice a year to vote on policy proposals. A proposal will be adopted as policy only if the board approves it. Rejected proposals are sent back to the appropriate committee to be reworked.

Changes implemented

The UNOS computer system is programmed to automatically consider the necessary elements when matching donor organs to patients awaiting a transplant.

Notify the transplant community

UNOS then informs transplant professionals about the change through a formal policy notice, emails about changes to the matching system, and through the OPTN evaluation plan (an online compliance tool for professionals).

An evolving forum

Continuing advances in the science and practice of organ transplantation require ongoing refinement of policy. To ensure the best possible solutions for patients awaiting transplantation, the policy development process is:

  • inclusive – encouraging participation by interested persons and organizations
  • responsive – assessing and modifying policies to remain current with the field
  • equitable – helping to ensure that all patients have an equal chance of receiving a suitable organ
  • evidence based – making decisions based on extensive and valid scientific data and analysis

Working together

A 42-member board of directors, who represent the diversity of professions and viewpoints within the field of organ transplantation, are assisted by more than 20 committees. These committees address a variety of specific perspectives and interests, including:

  • patient and donor family issues
  • medical issues specific to the various transplantable organs
  • needs and concerns of ethnic minorities and children needing transplants
  • technical aspects of organ recovery and matching
  • ethical principles
  • collection and reporting of scientific data
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