UNOS DonateLife

September 29, 2006

National Transplant System -- The First 20 Years

It's been 51 years since the first kidney transplant, so it may be surprising that we've only been sharing organs as a nation for the last 20 years.

Network created

In 1984, Congress passed the National Organ Transplant Act. In addition to prohibiting the sale of organs, it called for the creation of an Organ Procurement and Transplantation Network (OPTN) to develop national organ allocation policies to match available organs with transplant candidates based on medical criteria. In an unprecedented move, Congress stipulated that the OPTN would be a private entity operated by contract with the federal government. United Network for Organ Sharing (UNOS) won the first OPTN contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration and has operated the OPTN under federal contract since Sept. 30, 1986.

More transplants, increased need

Since the OPTN was created, nearly 400,000 people have received organ transplants in the United States and more than 200,000 of them are still alive today.

Challenges and opportunities

While the scope and mandate of the OPTN have changed with more of a focus on quality care and patient safety, the major challenges remain.

Transplantation takes off

The first year of the OPTN contract was also the first year that more than 10,000 transplants were performed in the United States. That number grew to more than 28,000 last year. During the same period, transplantation grew from an experimental procedure to routine medical therapy. Transplantation now provides hope for tens of thousands of people with end stage organ failure. The current waiting list of more than 92,000 men, women and children was only a fraction of itself at the end of 1980s when less than 20,000 people were listed.

Success skyrockets

Technology and medicine have come a long way. Doctors have an arsenal of techniques and medicines that didn't exist 20 years ago. While there is still a risk of patients rejecting their new organs and risks associated with the immunosuppression medicine they must take, it is much less than before. For example, survival rates have increased considerably since the 1980s. One-year patient survival rates approach or exceed 80 percent for each of the most common organ types transplanted. Graft survival is more important for kidneys; of those transplanted in recent years, more than two-thirds retain kidney function five years after transplantation.

Collaboration increases donation

In recent years, we've also seen record-breaking levels of organ donation. The number of deceased donors increased 18 percent in the last two years, from 6,457 in 2003 to 7,593 in 2005. This is attributed in part to the Organ Donation Breakthrough Collaborative, the federal government's initiative to save or enhance the lives of thousands each year by sharing and implementing known best practices in organ donation with the nation's largest hospitals to achieve organ donation rates of 75 percent or higher.

The trend continues

More lives were saved by organ transplantation in the month of May 2006 than in any month ever before, with 725 deceased organ donors in the United States that month.

Gift of Life

No matter how far medicine advances, the field of transplantation is a human endeavor. It is the only field of medicine that relies on public trust and the goodness of human nature, for the only way lives may be saved through organ transplantation is by a human being making the decision to give life.

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.