U.S. Organ Transplantation System - Its History, Present, and Future

The U.S. Organ Transplantation System is administered by the Health Resources and Services Administration, a division of the U.S. Department of Health and Human Services, and is contracted with the United Network for Organ Sharing (UNOS) to maintain the Organ Procurement and Transplant Network (OPTN). It is a very complex system whose goals are to ensure effectiveness, efficiency, and equity of organ sharing in the national system of organ allocation, as well as to increase the supply of donated organs available for transplantation. UNOS has been the only agency contracted by the OPTN since 1987. The OPTN has proposed changes to modernize and revamp the organ transplant system to improve access, equity, and transparency. There is a federal initiative to modernize the U.S. organ procurement system. The initiative includes the introduction of competitive bidding to administer the contract of the OPTN to provide de-monopolization of the infrastructure and bring more alternatives to improve the organization of the existing system.