Advocates open a new campaign to speed the next million transplants by encouraging more people to register as organ donors.

In the US, more than 400,000 people are living with functioning transplanted organs, UNOS said.
In the US, more than 400,000 people are living with functioning transplanted organs, UNOS said. (AA Archive)

The US counted its millionth organ transplant, a milestone that comes at a critical time for Americans still desperately waiting for that chance at survival.

It took decades from the first success — a kidney in 1954 — to transplant 1 million organs, a mark surpassed on Friday, and officials can’t reveal if this latest was a kidney, too, or some other organ. 

But advocates opened a new campaign to speed the next million transplants by encouraging more people to register as organ donors.

Yet the nation’s transplant system is at a crossroads. More people than ever are getting new organs — a record 41,356 last year alone. At the same time, critics blast the system for policies and outright mistakes that waste organs and cost lives.

The anger boiled over last month in a Senate committee hearing where lawmakers blamed the United Network for Organ Sharing (UNOS), a nonprofit that holds a government contract to run the transplant system, for cumbersome organ-tracking and poor oversight.

“This is sitting on your hands while people die,” Sen. Elizabeth Warren, D-Massachusetts, told the organisation’s chief executive as she and other senators suggested UNOS should be replaced.

UNOS continually takes steps to improve organ supply and equity and won’t be satisfied until everyone who needs a transplant gets one, CEO Brian Shepard responded.

Other experts say the fireworks are a distraction from work already underway.

“Everybody would like the system to be better,” said Renee Landers, a Suffolk University health law expert who, as part of an independent scientific advisory panel to the government, co-authored a blueprint for change earlier this year.

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5 year deadline

That blueprint, from the National Academies of Sciences, Engineering and Medicine, sets a five-year deadline for improving every part of the complex transplant system — including the groups that collect organs from deceased donors, transplant centres that decide which ones to use, and the government agencies that regulate both.

“Focusing on only one aspect is actually not going to achieve” that goal, Landers said. “There are so many other pieces that have to fall into place.”

In the US, more than 400,000 people are living with functioning transplanted organs, UNOS said Friday. For all the lives saved each year, more than 105,000 people are on the national list still waiting for a new kidney, liver, heart or other organ, and about 17 a day die waiting.

—OPOs are reluctant to retrieve less-than-perfect organs that they know nearby hospitals won’t accept. Some hospitals may always refuse kidneys from donors over 70 or diabetics, for example. But soon, transplant centres’ kidney acceptance rates will be tracked as a new quality measure.

To get ready, dozens of hospitals are using new computer filters to opt out of even receiving offers they don’t intend to accept. Skipping them could allow those offers to more quickly reach places like Yale University’s transplant centre — known for success with less-than-perfect kidneys — before the organs sit on ice too long to be usable.

“You can’t criticise OPOs for not recovering organs if you’re not beginning to hold transplant programmes accountable for the decisions they make,” said kidney specialist Dr. Richard Formica, Yale’s transplant medicine director. “We have to come up with ways to incentivise people to change their behaviors.

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