United States Trends in Procurement of Solid Organs Intended for Research

To examine national trends and regional variability in the procurement of solid organs recovered for research from deceased donors in the United States.

A retrospective cohort study of the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor registry data was conducted, including all deceased donors who underwent surgery for organ recovery from April 2015 to December 2023. The study classified each donated organ (liver, heart, pancreas, lung, kidney, and intestine) into four categories: not recovered, recovered for transplant, recovered for research, recovered for other purposes/discarded, with a focus on organs recovered for research.

Among 107,485 deceased organ donors across 58 organ procurement organizations (OPOs), organs recovered for research included 2491 intestines, 6494 hearts, 6627 livers, 9098 kidneys, 10,711 pancreata, and 13,025 lungs. Research organ recovery showed an upward trend, particularly for pancreata. Median percentage of organ recovery for research across the OPOs, varied significantly by organ type: intestines (65.4%), pancreata (36.1%), lungs (28.3%), heart (11.3%), liver (7.1%), and kidneys (3.8%), with no significant correlation between OPO donor organ volumes and research organ recovery rates. Analysis of the 2021 data showed a higher median percentage of research organ recovery in Tier 1 OPOs (13.8%) compared to Tier 2 (10.8%) and Tier 3 (11.4%), though these differences were not statistically significant (p = 0.18).

Given the opacity of existing practices and unrealized potential of research organs, our findings warrant the need for improved surveillance, centralized tracking, and a robust framework for research organ recovery.