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Organ Procurement Organizations

Increasing organ donation

About OPOs

Organ Procurement Organizations (OPOs) are not-for-profit organizations responsible for recovering organs from deceased donors for transplantation in the U.S. There are 56 OPOs, each mandated by federal law to perform this life-saving mission in their assigned donation service area.

The OPO’s role is to assess donor potential, collect and convey accurate clinical information, and follow national policies for offering organs. (It is the transplant hospital’s role to review organ offers and decide whether they are suitable for their patients.)

OPOs are on the front-line of organ procurement, and work directly with a decedent’s family during the emotional discussion about potential donation in order to facilitate the gift of life. For every successful match, the OPO facilitates authorization, testing, the recovery of donor organs and delivery to the transplant hospital.

Organ donation continues to grow

The U.S. system for organ donation and recovery is among the best in the world. No nation recovers more organs from deceased donors than we do. As a result of innovation and continuous improvement by the nation’s OPOs:

In 2023:

  • More than 16,000 deceased organ donors, a new annual record and a continuation of a 13-year annual-record trend
  • More than 46,000 organ transplants performed, continuing annual record-setting trend
  • More than 10,000 transplant recipients were Black, non-Hispanic
  • More than 10,000 liver transplants performed for the first time
  • More than 3,000 lung transplants performed for the first time
  • New annual records also set for kidney and heart transplants

The increases are significant given that only an estimated 3 percent of people die in a way that allows for organ donation.

How UNOS works with OPOs

The National Organ Transplant Act of 1984 (NOTA) was enacted to help ensure the organ allocation process is carried out in a fair and efficient way, leading to an equitable distribution of donated organs. This legislation established a national computer registry, called the Organ Procurement and Transplantation Network, for matching donor organs to waiting recipients. The OPTN is managed by UNOS, and all 56 OPOs use the UNOS proprietary computer system to match and place the organs that they procure.

UNOS provides tools, resources, and expertise to help OPOs improve the quality of service they provide, in order to achieve our joint goal of placing donated organs equitably and efficiently and saving more lives.


OPOs are certified by Centers for Medicare & Medicaid Services (CMS) and must abide by CMS regulations. CMS is the federal agency that assesses their performance.

UNOS doesn’t duplicate the authority CMS has. OPOs are required to collect and report key donor data to the OPTN and to the transplant hospitals receiving organ offers. This is to ensure the quality and safety of donated organs. UNOS also requires OPOs to document that they have followed other key legal and regulatory requirements, and we actively work with them to identify improvement opportunities for the services they provide.

Each state also has its own OPO requirements, and there are industry accreditation requirements.

Driving continuous improvement

UNOS is focused on improving OPTN system performance to ensure that the national network is as effective as it can be.

There are things that OPOs can do better individually and things that transplant hospitals can do better individually; neither can increase transplants alone. Both OPOs and transplant hospitals play a role in placing organs successfully and, ultimately, in broadening the donor criteria OPOs consider.

We believe that improvement is best driven by medical evidence and a thorough understanding of the real-life practice of donation and transplantation. UNOS, as the OPTN, recently convened the ad hoc Systems Performance Committee that identified a number of potential metrics and approaches to improve transplant system effectiveness—combining the efforts of OPOs and transplant hospitals. Key themes in the committee’s findings include the need for greater communication, transparency and accountability to foster improved donation and transplant community performance. The committee agreed these themes are integral to success for the transplant system as a whole, and may serve as a foundation for future work by the OPTN, other key stakeholders, regulatory bodies or the private sector.

UNOS tools and reports supporting OPO improvement

The Organ Utilization Tool (OUT) provides outcomes data to help OPOs increase local organ recovery rates and understand and influence organ acceptance behavior at centers in their donation service area.

The OPO Benchmark Report allows OPOs to easily compare their performance to others across the country to better understand and improve the organ recovery and placement process.

The Recovery and Usage Maps (RUM Report) provides detailed information about the recovery and transplantation of deceased donor kidneys to help expedite the placement of non-standard organs.

Read more

Our mission is to unite and strengthen the donation and transplant community to save lives.

About UNOS 

UNOS is a non-profit, charitable organization that serves as the nation’s Organ Procurement and Transplantation Network (OPTN) under contract with the federal government. The OPTN helps create and define organ allocation and distribution policies that make the best use of donated organs. This process involves continuously evaluating new advances and discoveries so policies can be adapted to best serve patients waiting for transplants. All transplant programs and organ procurement organizations throughout the country are OPTN members and are obligated to follow the policies the OPTN creates for allocating organs. 

For more information

Learn how Collaborative Improvement initiatives are helping OPOs and transplant hospitals to share effective practices, accelerating progress and improvement to increase donation and transplant nationwide.

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