US surpasses 1 million organ transplants, many more still needed

The United States recently hit a major medical milestone: 1 million successful organ transplants. But the work is far from over as more organs are desperately needed.

In 1954, doctors performed the first successful kidney transplant. In 2021, the U.S. saw 41,356 organ transplants performed — a record-breaking number, according to the Associated Press.

Now advocates for organ transplants are pushing for another million such surgeries in the coming years. Across the U.S., there are more than 400,000 people with functioning organs that were donated, the United Network for Sharing Organs said last week. But there are still some 105,000 people on the national organ waiting list, with kidneys being the most needed. The high demand also means many people are dying while waiting. The AP reported that 17 people die every day as they wait for organs to become available.

Yet the organ donation system is not working as effectively as it should be, according to a report earlier this year from the National Academies of Sciences, Engineering and Medicine. The organization said that there has been “significant nonuse of donated organs” as hospitals frequently turn down less-than-perfect organs. For example, one in five kidneys from deceased donors goes unused.

Many patients in dire need of kidneys are forced to wait longer than the National Academies says is appropriate because they’ve not been on the waiting list as long as other potential recipients. The National Academies report offered a solution in a news release on the report:

Around 84% of patients on the national transplant list are waiting for a kidney transplantation, the report says, and many are required to undergo dialysis until a kidney is available. The Organ Procurement and Transplantation Network (OPTN), which oversees all organ transplants in the U.S., should discontinue the practice of granting allocation “credits” or “points” to patients who accrue waiting list time before beginning dialysis. Early referral and listing is not possible for all patients needing kidney transplantation, especially the socioeconomically disadvantaged. Instead, waiting time “points” should be based on the date the patient began dialysis. The OPTN should closely monitor any unintended consequences of removing pre-dialysis waiting time points.

To reduce the nonuse of organs, the OPTN should make it easier for organ transplant centers to say “yes” to organ offers. Since donations occur seven days a week, the OPTN should require hospitals with transplant centers to better manage surgical scheduling, so organ procurement operations and transplants can take place in a timely manner every day. Organs at high risk of nonuse should go to transplant centers that have demonstrated a history of using — and willingness to accept — medically complex organs.

All organ transplant activists are united when it comes to one particular message: The U.S. needs more donors.