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

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


UNOS will undertake/propose the following action


Seek authorization for the OPTN to collect or receive data on intensive care unit (ICU)​ deaths for patients under age 70 for faster and more accurate monitoring of organ procurement organization (OPO) performance. As the OPTN begins to develop new OPO performance metrics, access to hospital death data would provide the OPTN the ability to offer near real‐time and targeted performance review and corresponding action plans for underperforming OPOs, based on an understanding of the true number of potential donors. The OPTN could also offer enhanced collaboratives and education based on the increased visibility these data would provide. The OPTN supports use of these data for regulatory purposes as well.


The OPTN will continue to advocate for a national investment in the automation of donor referral.1 Such a solution would provide a streamlined, independently reported data source on donor potential and has the potential to reduce the burden on already stressed ICU clinical staff by reducing manual data entry — the way many donor referrals are largely made today. In addition, it would ensure every potential donor is referred every time. Every hospital with the ability to ventilate patients would need to participate, a requirement that is beyond the authority of UNOS or the OPTN. Automated donor referral would be a significant innovation. Our nation has the technology to automate this important step, but it will not occur without a national commitment.2,3,4

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


1 “Recommendations: Beyond the OPTN.” OPTN Systems Performance Committee Report to the Board. June 2019.

2 Niles, Patricia; Hewlett, Jonathan; Piano, John; Liu, Wade. “Automated electronic referrals are changing donation.” Transplantation: September 2020 ‐ Volume 104 ‐ Issue S3 ‐ p S259 doi: 10.1097/

3 Glazier, A., Moss, M., & Martin, L. (2021). “Electronic Health Records Can Improve the Organ Donation Process.” Retrieved 20 Jan. 2022, from‐health‐records‐can‐improve‐the‐organ‐donation‐process.

4 “Cleveland Clinic, Lifebanc and Transplant Connect Develop Automated Donor Referral Process.” 30 April 2021.‐clinic‐lifebanc‐and‐transplant‐connect‐develop‐automated‐donor‐referral‐process/. Accessed 20 Jan. 2021.

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:

4. Transparency

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