6UNOS, 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.
7UNOS Organization Non-profit and charitable Membership organization Government contractorUNOS is a private, non-profit membership organization. It contracts with the federal government to operate the national transplant network.
8National Organ Transplant Act of 1984 (NOTA) Prohibited buying/selling organsCreated Organ Procurement and Transplantation Network (OPTN)Established Scientific Registry of Transplant RecipientsThe 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.
9What OPTN/UNOS Does Facilitates organ distribution, transplantation Establishes equitable policiesMaintains national transplant waiting listMonitors members for policy complianceCollects/validates/reports transplant dataPromotes organ availabilityThe 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.
10Who Are Our Members? As of May 2012 Transplant Centers 242Organ Procurement Orgs. 58Histocompatibility Labs 156Public Orgs. 6Medical/Scientific Orgs. 16Individual Members 7All 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.
11Organ Matching Donor organ Transplant Patients waiting National computer matching systemPotential recipient listTransplantThrough 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.Patientswaiting
12Organ Matching Criteria Medical urgencyTissue matchBlood typeWaiting timeOrgan sizeImmune statusGeographic distanceMany 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.
13UNOS Regional MapUNOS 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.
14Policy Development Issue Policy Process is flexible TransplantCommunityInputCommittee(s)IssuePublicCommentProcessBoard ofDirectorsPolicyUnder 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 flexibleMay take as little as 3 months or as long as several yearsCould involve thousands of individuals
15OPTN/UNOS Committees Organ Specific Thoracic Liver/Intestine Kidney PancreasOPOOrgan AvailabilityFinanceTransplant AdministratorsPolicy OversightInternational RelationsDisease Transmission AdvisoryMembership & Professional StandardsEthicsHistocompatibilityPatient AffairsMinority AffairsPediatricsLiving DonorTransplant CoordinatorsOperationsAbout 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.
16Deceased 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.
17Our Challenge The U. S. Organ Shortage 120,00090,00060,00030,000These 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.200120032005DonorsTransplantsPatients Waiting
18Promoting Organ Availability Public awareness through Donate Life America and local affiliatesIdentifying and sharing best practicesEducation/Collaboration involving transplant and other health professionalsUNOS 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.
19Lives 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.
20The 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.