1. needs a new heart to go on living . . .
A man in
Seattle
needs a new heart to go on living . . .
[Read from slide]

2. A Chicago woman’s liver
is failing . . .
[Read from slide]

3. A boy in Boston waits for a kidney to release him from daily
dialysis . . .
[Read from slide]

4. And a family in Denver decides to donate the organs of a family member who has died . . .
[Read from slide]

5. What’s the Connection? ?
[Read from slide]

6. UNOS, the United Network for Organ Sharing, matches donated organs to people who are waiting for transplants. Thanks to the generosity of one organ donor, each of these transplant patients can receive organs they desperately need to save or enhance the quality of their lives.

7. UNOS Organization Non-profit and charitable Membership organization
Government contractor
UNOS is a private, non-profit membership organization. It contracts with the federal government to operate the national transplant network.

8. National Organ Transplant Act of 1984 (NOTA)
Prohibited buying/selling organs
Created Organ Procurement and Transplantation Network (OPTN)
Established Scientific Registry of Transplant Recipients
The national transplant system was established by a federal law, the National Organ Transplant Act of This law made the buying and selling of organs a federal felony. It mandated the creation of both the Organ Procurement and Transplantation Network, or OPTN, which UNOS operates under federal contract. It also created a separate Scientific Registry of Transplant Recipients, to conduct analyses of transplant data. The Scientific Registry is operated under federal contract by Arbor Research, headquartered in Ann Arbor, Mich.

9. What OPTN/UNOS Does Facilitates organ distribution, transplantation
Establishes equitable policies
Maintains national transplant waiting list
Monitors members for policy compliance
Collects/validates/reports transplant data
Promotes organ availability
The national transplant system was established by a federal law, the National Organ Transplant Act of This law made the buying and selling of organs a federal felony. It mandated the creation of both the Organ Procurement and Transplantation Network, or OPTN, which UNOS operates under federal contract. It also created a separate Scientific Registry of Transplant Recipients, to conduct analyses of transplant data. The Scientific Registry is operated under federal contract by Arbor Research, headquartered in Ann Arbor, Mich.

10. Who Are Our Members? As of May 2012
Transplant Centers 242
Organ Procurement Orgs. 58
Histocompatibility Labs 156
Public Orgs. 6
Medical/Scientific Orgs. 16
Individual Members 7
All hospitals that operate transplant programs, and all agencies involved in organ recovery, are members of the organization and abide by its policies. Members also include independent labs that perform transplant services, medical and scientific organizations with a focus on transplantation, and individuals who have personal experience with organ donation or transplantation.

11. Organ Matching Donor organ Transplant Patients waiting
National computer matching system
Potential recipient list
Transplant
Through its computer matching system, UNOS receives and compares information on both available organs and patients waiting for a transplant. The computer system then generates a ranked list of candidates to be offered a particular organ.
Transplant centers are contacted in order of the patients listed for the organ offer. When a transplant center accepts a donor offer, arrangements are made to perform the transplant.
Patients
waiting

12. Organ Matching Criteria
Medical urgency
Tissue match
Blood type
Waiting time
Organ size
Immune status
Geographic distance
Many factors affect how candidates are matched with donor offers. There are individual policies for each organ type. But common factors considered for all organs include the blood type and size match between donor and recipient, how long the patient has waited for a transplant, and how far the organ would need to be transported between donor and recipient.
For organs including liver, heart and lung, priority is also given to medical urgency – how ill the candidate is at the present as compared to other patients. Those who are the most medically urgent are considered before less sick candidates.

13. UNOS Regional Map
UNOS is divided into 11 regions, both for organ distribution and for representation on its committees and board of directors. The size of each region is roughly scaled to the concentration of people within it. Regions that are geographically smaller have more people living in them than the larger regions.

14. Policy Development Issue Policy Process is flexible
Transplant
Community
Input
Committee(s)
Issue
Public
Comment
Process
Board of
Directors
Policy
Under the OPTN contract, UNOS is responsible for developing, studying and enhancing national organ transplant policy.
The policy-making process often begins with an issue that is discussed among members of the national transplant community. That issue could be a newly discovered problem or concern, or it could involve a new concept or medical practice that could improve the transplant system.
An OPTN/UNOS committee may study the issue further and develop a proposal for public comment. Based on comments received, the committee may revise the proposal and present it to the OPTN/UNOS Board of Directors for approval.
UNOS continually seeks to improve transplant policy. There are many opportunities to seek input and refine policies. Some issues go from discussion to final adoption in a few months; others take years to develop. Based on the level of interest and public comment, potentially thousands of people may be involved in the process.
Process is flexible
May take as little as 3 months or as long as several years
Could involve thousands of individuals

15. OPTN/UNOS Committees Organ Specific Thoracic Liver/Intestine Kidney
Pancreas
OPO
Organ Availability
Finance
Transplant Administrators
Policy Oversight
International Relations
Disease Transmission Advisory
Membership & Professional Standards
Ethics
Histocompatibility
Patient Affairs
Minority Affairs
Pediatrics
Living Donor
Transplant Coordinators
Operations
About 20 committees study issues and make policy recommendations to the OPTN/UNOS Board of Directors. Some committees involve specific organ types or professions within the transplant field. Others represent perspectives or disciplines that are needed to understand the full impact of potential actions the Board may take.
Committee members (and Board members) volunteer their time and expertise – UNOS only pays travel, lodging and meal expenses for meetings. These members reflect a diverse U.S. population, as well as the different professions and perspectives involved in transplantation.
One unique aspect of OPTN/UNOS committees is representation by people who have a personal connection to donation or transplantation. They may be a living donor, a transplant recipient, or a family member of a deceased donor or a recipient. Thus we seek to balance professional expertise with the perspectives of people directly affected by the transplant network.

16. Deceased and Living Donors 2002 - 2011
The number of deceased donors has remained largely the same over the last six years but has increased more than 10 percent from the total eight years ago. Living donation has varied somewhat after reaching a peak in We expect living donation to increase again through the growing use of kidney paired donation.

17. Our Challenge The U. S. Organ Shortage
120,000
90,000
60,000
30,000
These increases in donation allowed nearly 30,000 organ transplants to be done in Yet the demand for transplantation continues to grow at a strong pace. The transplant waiting list exceeded the 100,000 mark in 2008.
The kidney is the organ most commonly transplanted and most commonly needed. As more people in the United States develop end-stage kidney failure, the number of people seeking transplantation also increases.
2001
2003
2005
Donors
Transplants
Patients Waiting

18. Promoting Organ Availability
Public awareness through Donate Life America and local affiliates
Identifying and sharing best practices
Education/Collaboration involving transplant and other health professionals
UNOS is involved with a number of efforts to make more transplantable organs available.
UNOS was a founder of Donate Life America, a separately chartered non-profit organization whose sole focus is promoting public awareness of and commitment to donation. UNOS continues to support the efforts of Donate Life America and its affiliate local chapters.
UNOS also supports a series of efforts to identify best practices – local strategies that work well to increase donor consent or successfully transplant more organs. Those practices are then shared and implemented in other local areas. The goal is overall system improvement in donation and transplantation.
In addition, UNOS conducts collaborative education with transplant professionals, and other professionals who are involved in the donation process. The goal is to ensure the most supportive environment for organ donation and recovery.

19. Lives Transplants Save
Every day, organ transplants save and enhance the lives of men, women and children. Many transplant recipients have survived 20 years or longer; a few kidney recipients have now lived 40 years or more with a functioning transplant. More than a quarter million Americans are alive today thanks to transplantation.
Yet many people remain in need. We rely on the public’s willingness to commit to organ donation to continue our life-giving mission.

20.
The UNOS web site, unos.org, has much more information about what we do and about the status of organ donation and transplantation in the United States.