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Actions to strengthen the U.S. organ donation and transplant system

Driving system-wide improvement to better serve patients

2023 Congressional Action

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More than 42,800 organ transplants were performed in the U.S. in 2022, an increase of nearly 1,500 over the previous year. The system’s success reflects its commitment to continuous improvement, which has driven 10 consecutive years of increases in the number of deceased-donor transplants performed. Thanks to the efforts of the national transplant network, 23 percent more deceased-donor transplants are performed today than five years ago.

But there is more work to do.

UNOS action agenda overview


More than 100,000 people are waiting for a transplant. Every day, they count on the organ donation and transplant community to do everything it can to strengthen the system and ensure that patients have equitable access to lifesaving organs.

United Network for Organ Sharing (UNOS), the mission driven non-profit that serves as the Organ Procurement and Transplantation Network (OPTN) under contract with the federal government, is proposing reforms that will improve the U.S. organ donation and transplant system. We have also outlined changes to the OPTN contract that we believe will hold all parts of the system accountable to better serve the patients who rely on us every day. Below, we have detailed:

  • Actions we are taking now and will take soon, as they are currently within UNOS’ capabilities and/or within the authority of the current OPTN contract
  • Tasks UNOS recommends are added to and funded within future OPTN contracts

Actions and recommendations

How we plan to meet the needs of the broader donation and transplant community

UNOS published the Action Agenda on Jan. 30, 2023, to reflect the needs of the broader donation and transplant community. As we progress on the actions and recommendations outlined, we will post updates here accordingly.

“Our national donation and transplant system saves thousands of people’s lives every year, but as long as there are patients on the waiting list, there is more we need to do.”

Maureen McBride, Ph.D.


Patient empowerment

Increase direct services and resources to patients, donors, caregivers and families


Improve equity in access to the transplant healthcare system

Data collection

Enable the OPTN to collect donor potential data directly from hospitals to drive improvement in OPOs, diversify donor pool


Increase transparency in OPO, hospital and system performance by making more comparative performance data available publicly


Reduce risk of organ delay, damage or loss in transport

IT improvement

Maintain safe, modern and reliable systems and infrastructure


Enhance oversight and increase transparency of peer review process


Make the OPTN an organization independent of the OPTN contractor

All stakeholders, including UNOS, share a common mission:

Get as many usable transplant organs as possible to patients who need them, fairly, equitably and efficiently.

All parts of the national system must be held accountable for making sure that this happens. The OPTN contractor must provide the highest level of service to patients and the greatest level of transparency to the public who has charged it with this lifesaving work.

“We can do better, we must do better, and we will do better.”

Maureen McBride, Ph.D.


Up next:

1. Patient empowerment

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