United Network for Organ Sharing

American non-profit organization

It has been suggested that this article be split into a new article titled Organ Procurement and Transplantation Network. (Discuss) (March 2024)

|

"UNOS" redirects here. For the pizzeria restaurant chain, see Uno Chicago Grill. For the operating system, see μnOS.

United Network for Organ Sharing

Abbreviation| UNOS
Founded| March 21, 1984; 41 years ago (1984-03-21)[1]
Founder| Gene A. Pierce

Tax ID no.

| 54-1327878[2]
Legal status| 501(c)(3) nonprofit organization[2]
Headquarters| Richmond, Virginia, U.S.[3]
Coordinates| 37°32′52″N 77°26′05″W﻿ / ﻿37.547899°N 77.434782°W﻿ / 37.547899; -77.434782
Services| Manages the U.S. organ transplant system under contract with the federal government by bringing together transplant and organ procurement professionals and volunteers in order to make life-saving organ transplants possible.[3]

Chief Executive Officer

| Brian Shepard[3]

President

| David Mulligan, MD, PhD[3]
Subsidiaries| UNOS Foundation (501(c)(3))[3]
Revenue| $57,665,464[3] (2016)
Expenses| $51,727,331[3] (2016)
Employees| 394[3] (2015)
Volunteers| 500[3] (2015)
Website| unos.org

The United Network for Organ Sharing (UNOS) is a non-profit scientific and educational organization that administers the only Organ Procurement and Transplantation Network (OPTN) in the United States, established (42 U.S.C. § 274) by the U.S. Congress in 1984 by Gene A. Pierce, founder of United Network for Organ Sharing. Located in Richmond, Virginia, the organization's headquarters are situated near the intersection of Interstate 95 and Interstate 64 in the Virginia BioTechnology Research Park.

## Activities

[edit]

United Network for Organ Sharing is involved in many aspects of the organ transplant and donation process:

* Managing the national transplant waiting list, matching donors to recipients.
* Maintaining the database that contains all organ transplant data for every transplant event that occurs in the U.S.
* Bringing together members to develop policies that make the best use of the limited supply of organs and give all patients a fair chance at receiving the organ they need, regardless of age, sex, ethnicity, religion, lifestyle, or financial/social status.
* Monitoring every organ match to ensure organ allocation policies are followed.
* Providing assistance to patients, family members and friends.
* Educating transplant professionals about their important role in the donation and transplant processes.
* Educating the public about the importance of organ donation.

## History

[edit]

United Network for Organ Sharing was awarded the initial Organ Procurement and Transplantation Network contract on September 30, 1986, and it is the only organization to ever manage the Organ Procurement and Transplantation Network.

United Network for Organ Sharing provides the Organ Procurement and Transplantation Network with a functional, effective management system incorporating the Board of Directors, committees and regional membership to operate OPTN elements and activities.[4]

In late December 2013, it was announced that United Network for Organ Sharing had developed new policies and regulations governing the new field of hand and face transplants like it does standard organ transplants, giving more Americans who are disfigured by injury or illness a chance at reconstruction. In July 2014, government regulations went into effect making hand and face transplants subject to the same oversight by United Network for Organ Sharing as heart or kidney transplants.[5] The rules mean potential transplant recipients will be added to the United Network for Organ Sharing network, for matching of donated hands and face tissue to ensure correct tissue type and compatibility for skin color, size, gender and age. Transplants and their outcomes will be tracked.[6]

In 2020, the Senate Finance Committee launched a bipartisan investigation into UNOS, seeking information into various abuses and patient harms.[7] In 2022, the committee published a bipartisan report concluding that "From the top down, the U.S. transplant network is not working, putting Americans’ lives at risk.".[8] UNOS has also come under intense scrutiny for issues related to outdated and insecure technology,[9] as well as failing to address fatal patient safety risks[10] and anti-patient misinformation.[11]

An investigation by the United States Senate Committee on Finance published in August 2022 catalogs over a thousand complaints from the previous decade, including patient deaths and injuries caused by failures to check for disease and match blood type.[12] At an oversight hearing, Senator Elizabeth Warren pointed out that "UNOS is 15 times more likely to lose or damage an organ in transit as an airline is to lose or damage your luggage."[13] Temperature regulation during transport can also be problematic.[14]

## Regions

[edit]

The regions of United Network for Organ Sharing

United Network for Organ Sharing and Organ Procurement and Transplantation Network operate by grouping states into several different regions throughout the country.[15]

1. Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Eastern Vermont
2. Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, West Virginia, and the part of Northern Virginia in the Donation Service Area served by the Washington Regional Transplant Community (DCTC) Organ procurement organization
3. Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, and Puerto Rico
4. Oklahoma and Texas
5. Arizona, California, Nevada, New Mexico, and Utah
6. Alaska, Hawaii, Idaho, Montana, Oregon, and Washington
7. Illinois, Minnesota, North Dakota, South Dakota, and Wisconsin
8. Colorado, Iowa, Kansas, Missouri, Nebraska, and Wyoming
9. New York and Western Vermont
10. Indiana, Michigan, and Ohio
11. Kentucky, North Carolina, South Carolina, Tennessee, and most of Virginia

## Allocation

[edit]

United Network for Organ Sharing uses a set policy to remove as much subjectivity as possible from the process of matching organs with recipients (referred to as a "match run").[16][17] There are several factors that are involved, including, but not limited to:

* Age
* Ability of the patient to recover
* ABO (though very young recipients are often considered for ABO-incompatible listing)
* Distance
* Height and weight
* Life support status
* Listing status
* Time on the waiting list

The individual criteria varies from one organ type to another. For example, with heart and lung transplantation, candidate recipients are given one of four status levels (1A - the highest level, 1B, 2, and 7).[18] A matching born (i.e. not in utero) candidate of Status 1A within the donor region, of matching ABO type, and within 500 miles will be given the highest priority, with multiple matches being ranked by time on the waiting list.[18] Each of those criteria will be progressively relaxed until a match is found.[18]

Some healthy organs that are donated go to waste despite about 20 people dying per day while on waiting lists. Critics state that this is because once a given set of organs are turned down once or twice, other potential recipients begin to be concerned about the condition of the organs, and eventually the organs are destroyed after thousands of refusals. Excessive conservatism may be the result of evaluating transplant surgeons based on success rate, giving them an incentive only to attempt procedures with the highest probability of success, rather than maximizing the number of lives saved. New rules announced by the Department of Health and Human Services in 2020 aimed to better balance waiting lists in different regions caused by demographic differences in causes of death.[19]

## Membership

[edit]

United Network for Organ Sharing has five classes of members, with varying levels of rights and obligations.[15][20]

* Institutional members: Regional organ procurement organizations (such as Gift of Hope), hospitals that perform transplantation, or histocompatibility laboratories that serve the aforementioned hospitals.
* Medical/scientific members: Professional organizations whose membership serve the field of transplantation, such as the American Society of Transplant Surgeons or the American Academy of Pediatrics.
* Public organization members: Organizations that serve to support transplant donors, recipients, and their families, such as National Kidney Foundation or the American Diabetes Association, or hospitals that refer donors but do not themselves perform transplants.
* Business members: Companies that do business with two or more institutional members.
* Individual members: Current or former members of the UNOS Board of Directors; Members or family of transplant candidates, donors, recipients; or other individuals who are or were involved in the field of or regulation of organ donation and transplantation, including employees of institutional members.

## Leadership

[edit]

UNOS, and by extension, the OPTN elects its presidents to a one-year term. Prior to serving that term, they serve for one year as Vice President. After their term as President, they then serve for one year as Immediate Past President. This allows for a more orderly transition between leadership.

### List of UNOS/OPTN Presidents

[edit]

* 1984-1985: G. Melville Williams, MD, Medical College of Virginia[21]
* 1985-1986: Oscar Salvatierra Jr., MD
* 1986-1988: John C. McDonald, MD
* 1988-1989: H. Keith Johnson, MD
* 1989-1990: Robert Corry, MD
* 1990-1991: James S. Wolf, MD
* 1991-1992: Robert Mendez, MD
* 1992-1993: R. Randal Bolinger, MD
* 1993-1994: Douglas J. Norman, MD
* 1994-1995: Margaret D. Allen, MD
* 1995-1996: Bruce A. Lucas, MD
* 1996-1997: James Burdick, MD
* 1997-1998: Lawrence Hunsicker, MD
* 1998-1999: William Pfaff, MD
* 1999-2000: William D. Payne, MD
* 2000-2001: Patricia Adams, MD
* 2001-2002: Jeremiah G. Turcotte, MD, University of Michigan Medical Center
* 2002-2003: Clyde F. Barker, MD
* 2003-2004: Russell Wiesner, MD, Mayo Clinic
* 2004-2005: Robert A. Metzger, MD
* 2005-2006: Francis L. Delmonico, MD, FACS, Harvard Medical School
* 2006-2007: Sue V. McDiarmid, MD, UCLA Medical Center
* 2007-2008: Timothy L. Pruett, MD, University of Minnesota Medical Center
* 2008-2009: Robert S. D. Higgins, MD, Johns Hopkins School of Medicine
* 2009-2010: James Wynn, MD, Medical College of Georgia
* 2010-2011: Charles Alexander, RN, MSN, MBA, CPTC
* 2011-2012: John R. Lake, MD, University of Minnesota Medical Center
* 2012-2013: John P. Roberts, MD, University of California San Francisco Medical Center
* 2013-2014: Kenneth A. Andreoni, MD, Shands Hospital at University of Florida
* 2014-2015: Carl L. Berg, MD, Duke University Hospital
* 2015-2016: Betsy Walsh, JD, MPH, Novant Health
* 2016-2017: Stuart C. Sweet, MD, Washington University in St. Louis School of Medicine
* 2017-2018: Yolanda T. Becker, MD, University of Chicago Medicine
* 2018-2019: Sue Dunn, RN, BSN, Donor Alliance
* 2019-2020: Maryl R. Johnson, MD, FACC, UW School of Health
* 2020-2021: David Mulligan, MD, FACS, Yale School of Medicine
* 2021-2022: Matthew Cooper, MD, FACS, MedStar Georgetown University Hospital
* 2022-2023: Jerry McCauley, MD, MPH, Thomas Jefferson University Hospital[22]
* 2023-2024: Dianne LaPointe Rudow ANP-BC, DNP, FAAN, Mount Sinai Medical Center
* 2024-2025: Richard Formica, MD, Yale New Haven Hospital
* 2025-2026: Lloyd Ratner, MD, MPH, FACS, FICS(Hon), Columbia University

## References

[edit]

1. ^ "United Network for Organ Sharing". Virginia State Corporation Commission. Retrieved July 17, 2018.
2. ^ a b "United Network for Organ Sharing". Tax Exempt Organization Search. Internal Revenue Service. Retrieved July 17, 2018.
3. ^ a b c d e f g h i "Form 990: Return of Organization Exempt from Income Tax". United Network for Organ Sharing. Guidestar. September 30, 2016.
4. ^ "UNOS | United Network for Organ Sharing | US Organ Transplantation". UNOS.
5. ^ "OPTN: Organ Procurement and Transplantation Network". optn.transplant.hrsa.gov. Archived from the original on 2014-01-10.
6. ^ AP (26 December 2013). "UNOS To Oversee Hand, Face Transplants Like Organs". WeeklyTimes. Retrieved 26 December 2013.
7. ^ "Finance Committee Members Probe U.S. Organ Transplant System | The United States Senate Committee on Finance". www.finance.senate.gov. Retrieved 2023-04-26.
8. ^ "Hearing - - "A System in Need of Repair: Addressing Organizational Failures of the U.S.'s Organ Procurement and Transplantation Network"" (PDF).
9. ^ "Thousands of lives depend on a transplant network in need of 'vast restructuring'". The Washington Post. 2022-07-31. Archived from the original on 2023-03-22.
10. ^ "70 deaths, many wasted organs are blamed on transplant system errors". Washington Post. ISSN 0190-8286. Retrieved 2023-04-26.
11. ^ "Heartless: Organ Donation Contractors Lobby Against a Popular Health Care Initiative While Pocketing Pandemic Relief Loans". Project On Government Oversight. 5 October 2020. Archived from the original on April 4, 2023. Retrieved 2023-04-26.
12. ^ "Wyden Statement at Finance Committee Hearing on the Urgent Need to Address Failures in the Organ Transplant System | The United States Senate Committee on Finance". www.finance.senate.gov. Retrieved 2023-04-26.
13. ^ Farmer, Blake (August 17, 2022). "Transplant agency is criticized for donor organs arriving late, damaged or diseased". NPR. Archived from the original on June 22, 2024.
14. ^ "Cambridge company attempts to create 'full service' transit system for organ transplants". www.wbur.org. 8 September 2022. Retrieved 2023-04-26.
15. ^ a b "Organ Procurement and Transplantation Network Bylaws. United Network for Organ Sharing" (PDF). United Network for Organ Sharing. 2012-12-13.
16. ^ United Network for Organ Sharing. (2013, January 31). OPTN Policy 3.2 - Waiting List. United Network for Organ Sharing. Retrieved from http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp Archived 2013-12-07 at the Wayback Machine
17. ^ United Network for Organ Sharing (2013). OPTN Policy. Archived 2013-12-07 at the Wayback Machine from the original
18. ^ a b c United Network for Organ Sharing. (2013, January 31). OPTN Policy 3.7 - Allocation of Thoracic Organs. Retrieved from http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp Archived 2013-12-07 at the Wayback Machine
19. ^ "Organ Donation Nonprofits Face New Scrutiny Under Trump Administration Rules". NPR. Archived from the original on 2023-05-11.
20. ^ OPTN Member Directory. (n.d.). OPTN Member Directory. Organ Procurement and Transplantation Network. Retrieved May 1, 2013, from http://optn.transplant.hrsa.gov/members/search.asp
21. ^ Cindyyoung (2020-08-31). "In Memoriam: G. Melville Williams, M.D." UNOS. Retrieved 2021-01-07.
22. ^ "New board members elected in 2021 - OPTN".

## External links

[edit]

* Official sites:
* Main UNOS site.
* Main OPTN site, with data reports and policies, operated by UNOS on behalf of the Health Resources and Services Administration.
* Transplant Living, for post-transplant recipients and living donors.
* UNOS Meeting Partners, an event-planning service for transplantation-related organizations, including UNOS itself.
* National Donor Memorial
* United for UNOS, which serves to facilitate UNOS community outreach.
* Scientific Registry of Transplant Recipients, related statistical site also operated for the HRSA.

* v
* t
* e

Organ transplantation

Types|

* Allotransplantation
* ABOi
* Autotransplantation
* Xenotransplantation

Organs and tissues|

* Bone
* Bone marrow
* Brain
* Corneal
* Eye
* Face
* Hand
* Head
* Heart
* Heart–lung
* Intestine
* Kidney
* Liver
* Lung
* Pancreas
* islet cell
* Penis
* Skin
* Spleen
* Thymus
* Pulmonary artery
* Uterus
* Vagina

Medical grafting|

* Bone grafting
* Skin grafting
* Vascular bypass

Organ donation|

* Non-heart-beating donation
* Organ procurement
* Organ trade

Complications|

* Graft-versus-host disease
* Post-transplant lymphoproliferative disorder
* Transplant rejection

Transplant networks
and government
departments|

* Eurotransplant
* Gift of Life Marrow Registry
* Human Tissue Authority
* LifeSharers
* National Marrow Donor Program
* NOD-Lb
* National Transplant Organization
* NHS Blood and Transplant
* Trillium Gift of Life Network
* United Network for Organ Sharing

Advocacy
organizations|

* Anthony Nolan
* Blood Cancer UK
* DKMS
* Halachic Organ Donor Society
* Kidney Foundation of Canada
* National Kidney Foundation
* ORGANIZE

Joint societies|

* American Society of Nephrology
* American Society of Transplantation
* Canadian Society of Transplantation

Countries|

* Organ transplantation in China
* harvesting from Falun Gong
* Organ donation in India
* Gurgaon kidney scandal
* Organ transplantation in Israel
* Organ transplantation in Japan

People|

| Heart|

* Christiaan Barnard
* James D. Hardy
* Adrian Kantrowitz
* Richard Lower
* Norman Shumway

|

Kidney|

* J. Hartwell Harrison
* John P. Merrill
* Joseph Murray
* Elizabeth Ward
* Michael Woodruff

Liver|

* Fikri Alican
* James D. Hardy
* Thomas Starzl

Lung|

* Fikri Alican
* Joel D. Cooper
* Vladimir Demikhov
* James D. Hardy

Pancreas|

* Richard C. Lillehei

Penis|

* André van der Merwe

Pulmonary Artery|

* Stefano Cafarotti

Other|

* Alexis Carrel
* Jean-Michel Dubernard
* Donna Mansell
* Bruce Reitz

* List of organ transplant donors and recipients

Related topics|

* Biomedical tissue
* Edmonton protocol
* Eye bank
* Immunosuppressive drugs
* Lung allocation score
* Machine perfusion
* Total body irradiation
* Frankenstein's monster

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