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

Driving system-wide improvement to better serve patients

Congressional Action

Workgroup to study how organs can once again travel safely in the cabin of commercial flights. Learn about bill.

Thanks to the efforts of the national transplant network, more than 46,000 organ transplants were performed in the U.S. in 2023, an increase of more than 3,200 (8.9 percent) over the previous year. The system’s success reflects its commitment to continuous improvement, which has driven 13 consecutive years of increases in the number of deceased-donor transplants performed.

But there is more work to do.

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) is proposing reforms that will improve the U.S. organ donation and transplant system. We have also outlined changes to the Organ Procurement and Transplantation Network (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

The UNOS Action Agenda reflects the needs of the broader donation and transplant community.

“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.


At a glance
UNOS and the donation and transplant system

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 transplantable 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 transplant community and the OPTN must provide the highest level of service to patients and the greatest level of transparency to the public who have charged them with this lifesaving work.

Up next:

1. Patient empowerment

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