Public policy

Clear Metrics to Increase the Number of Organ Donors and Organs Available for Transplantation

The American Society of Transplantation would like to call your attention to the need for clear metrics for Organ Procurement Organizations (OPOs) to increase the number of organ donors and organs available for transplantation.


What is the problem we are trying to solve?

OPOs need clear metrics for measuring performance that will not inhibit innovation or dissuade recovery of organs from any viable donor. The current metrics may have unintended consequences that result in disincentive to identify and recover organs from donors that are considered higher risk. Modification of metrics that encourage consent of all eligible donors and utilization of all available organs for transplantation may expand the availability of life-saving transplant procedures.


Why Aren’t More People Being Transplanted?

In 2016, there were 15,945 organ donors in the United States. This included 9,970 deceased donors and 5,975 living donors[i]. While this number seems impressive when considered in isolation, there are currently 118,472 people awaiting an organ transplant as of March 10, 2017 per the Organ Procurement and Transplantation Network (OPTN) website[ii].

For many complex and logistical reasons, not all potentially viable donors are identified and consented in a timely manner that may facilitate organ donation. Additionally, current metrics used to evaluate the performance of OPOs do not encourage the procurement of organs from donors that have risk factors that may render some organs non-viable for transplantation. In some cases, there may be disincentives to recovering organs from donors who will not be able to supply multiple organs.  OPOs that do not meet current performance standards may receive significant punitive repercussions from regulatory agencies or potentially lose public funding needed to support their function.

Every potential deceased donor organ offers a life-saving gift to patients with end-stage organ disease. Quality metrics have been shown to significantly adversely alter practices and there is significant concern that the current metrics to evaluate OPOs discourage the potential use of all viable donor organs.


How Can We Solve This Problem?

There is compelling need to coordinate efforts among regulatory agencies to develop metrics that encourage OPOs to identify all viable organs. These efforts will increase the availability of organs and allow for more live-saving organ transplants.


Approved by the AST Executive Committee on April 4, 2017

For a printable PDF version, please click here.


[ii] OPTN waiting list data, website accessed 3/10/2017: