organ transplantation, the donor and recipient were often in the same building. Gradually, a system of independent organizations, Organ Procurement Organizations (OPOs), developed to optimize matching of patients with donated organs. OPOs identified donors, retrieved organs, and found recipients within a reasonable time frame.

The designated geographic areas served by the various OPOs range in size from a few counties, to entire states, to multi-state areas covering parts or all of several states (see Figure 1-1).* The populations of these areas range from approximately 700,000 to 11,000,000 (DHHS, 1999b). In each area, only one OPO coordinates activities relating to organ procurement and allocation, and that OPO is required to have a working arrangement with all hospitals in its designated area. OPOs evaluate potential donors, discuss donation with family members, and arrange for the surgical removal of donated organs. OPOs also are responsible for preserving organs and arranging for their distribution according to nationally, regionally, or locally agreed upon organ-sharing policies.

TABLE 1-2 UNOS National Patient Waiting List for Organ Transplants

Type of Transplant

Registrations for Transplanta

Patients Waiting for Transplantb

Kidney

43,734

41,833

Liver

13,181

12,987

Heart

4,267

4,248

Lung

3,299

3,250

Kidney-pancreas

1,915

1,847

Pancreas

453

442

Heart-lung

248

244

Intestine

120

120

Pancreas islet cell

118

118

Total

67,335

63,219

a UNOS policies allow patients to be listed with more than one transplant center (multiple listing); thus, the number of registrations is greater than the actual number of patients.

b Some patients are waiting for more than one organ; therefore, the total number of patients is less than the sum of patients waiting for each organ.

SOURCE: Based on UNOS Scientific Registry data as of May 12, 1999.

*  

 Figure 1-1 shows the 63 OPOS as they were in 1997. There are presently 62 OPOs, but the precise boundaries had not been determined at the time of publication of this report.



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