Author: Anuhya Banerjee
Most likely at one point you’ve filled out DMV forms and came across a part of the application that asks you to opt to become an organ donor. And if not, then perhaps you’ve watched Grey’s Anatomy and have become familiar with the organization UNOS (hey, I’m not judging!). Organ transplantations have an extensive medical history and have been vital in the lives of many recipients and donors. Regardless of background, there has always been a deficit in this system that continually needs to be acknowledged and educated upon.
UNOS stands for the United Network for Organ Sharing, and functions as the only private non-profit organization that manages the United States organ transplant system. In October of 1984, Congress approved the National Organ Transplant Act (NOTA) which built the foundations for a transplant system that is efficient, fair, law-abiding, and looked up to worldwide. More importantly, it established the Organ Procurement and Transplantation Network (OPTN).
A common question is: What is the difference between UNOS and OPTN?
This gets more into the foundations of what is called a public-private partnership. In the way that organ transfers work, the whole infrastructure to organ transplants in America is dependent on private companies and the federal government. Essentially, the relationship between them according to UNOS.org is that “UNOS serves as the OPTN under contract with the U.S. Department of Health and Human Services (DHHS).” So, while UNOS is its own private organization (and the only organ transplant organization in the U.S.), organ allocation is allowed to happen only through the Organ Procurement and Transplantation Network.
UNOS serves the United States, however many countries have their own services in the organ allocation industry. For example, in Canada, the Canadian Council for Donation and Transplantation (CCDT) was created in 2001 and coordinated organ transplantation/donation at provincial and national levels. However, in 2008, the Canadian Blood Drive agency assumed the roles of the CCDT and merged companies. In the geographical location of Québec, Transplant Québec functions as the area’s organ allocation services. All over the world, donors and recipients connect through their country’s assets to continue connections in fundamental necessities for life.
With such a precious resource of life, we can find disparities and holes in the system, just like many others. Such scarcities bring up the topic of ethics with the organ allocation controversy. Donors are matched up with recipients on a multitude of factors, such as blood type, genetic attributes, and size. However, past those, your geographical location (local and state availability) heavily impacts your likelihood of receiving an organ. Senators, as of April 2020, have been involved in a policy that brings up the inequality in a system that is based upon a regional level, to be improved upon with a national basis for organ donation. This would address the longer organ wait times among registries, such as New Yorkers having to wait 4 times as long as a Kansas resident for a liver (Koerth). While there may always be a deficit and uneven distribution with potential organ donors, organs do not have to go through the same unequal registry.
Comparison of donors versus number of waiting patients
Beyond the national registries and legal capabilities, a concern for organ trafficking takes place throughout many countries. Typically these organs are sold on the black market, and transplant tourism is marked by the buying, selling, or receiving of organs. The Council of Europe cites figures that this industry is worth between $600 million and $1.2 billion every year. Countries around the world and the United Nations continue to prevent the spread and address the dangerous agenda of this illicit activity.
The ABC’s of the Organ Transplant industry all the way up to Z really does exist: accountability, background, controversy, donors, etc... Though utility, justice, and respect remain to be the guiding principles of the OPTN and for many countries around the world. There is a lot more information out there upon Organ Donors and it is encouraged to sign up to be one through Donate Life America, UNOS, or OrganDonor.gov. Currently 110,000+ men, women, and children are on the list and you can help make an impact.