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

Governance: Make the OPTN an organization independent of the OPTN contractor


For nearly 40 years, the governing boards of UNOS and of the OPTN were the same. This was due to a provision in the OPTN contract UNOS has held with the federal government to manage the nation’s organ donation and transplant system.

UNOS Action

In alignment with HRSA’s Modernization Initiative, UNOS undertook steps to establish a governance structure for UNOS that would be independent of the OPTN board of directors. In December 2023, the UNOS board of directors voted to eliminate the overlap of board membership, and in February 2024, UNOS members voted to ratify that decision. Having two independent boards will increase accountability, transparency and good governance, leading to greater public trust in the national system.

As of March 30, 2024, UNOS has a separate, seven-member board that is independent from the OPTN 42-member board.

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

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.

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