As we celebrate Gift of Life’s exciting milestone and ongoing successes, the Penn Lung Transplant team thought it would be the perfect time to share some helpful information about the organ donation and transplant system in the United States and the critical role played by organ procurement organizations (OPOs).
When did OPOs begin to connect donors and recipients?To answer that question well, we’ll need to take a quick look back to understand the beginnings of donation and transplantation. In 1967, when Penn surgeons were among the first in the country to begin doing kidney transplants, kidneys were only recovered from living donors. When brain death protocols came into practice and organs from deceased donors became an option, organs recipients were identified from a small geographic area – in very close proximity to where the organ donor died. This made transplantation an option for a small percentage of people who needed transplants.
As advances in transplant surgery evolved and the first medicine to stop organ rejection was approved by the Federal Drug Administration, more organs were able to be transplanted. Transplant continued to become an effective treatment for end-stage organ failure; it became clear that a national system was needed to fairly distribute deceased donor organs to those who needed them.
In 1984, the National Organ Transplant Act (NOTA) was signed into law. This law created the Organ Procurement and Transplant Network (OPTN) for matching donor organs to waiting recipients and is administered through the United States Department of Health and Human Services Health Resources Administration. NOTA also called for the responsibilities of the OPTN to be carried out by a private, non-profit organization under federal contract. The United Network of Organ Sharing (UNOS) was awarded the contract in 1986 and continues to administer the OPTN today.
What does UNOS do?The primary goals of UNOS are to:
- Increase and ensure the effectiveness, efficiency and fairness of organ sharing in the national system of organ allocation
- Increase the supply of donated organs available for transplantation
To effectively and efficiently allocate donated organs, UNOS divided the country into regions. Here’s the map of UNOS regions:
UNOS regions are served by one or more organ procurement organization and states can also be served by more than one organ procurement organization. For example, Penn Transplant is in state of Pennsylvania, which is in UNOS region two and there are two organ procurement organizations serving the state of Pennsylvania – Gift of Life Donor Program (serving eastern Pennsylvania) and the Center for Organ Recovery and Education (serving western Pennsylvania).
The local area served by an organ procurement organization is called its “service area”. Gift of Life’s service area is eastern Pennsylvania, southern New Jersey and the state of Delaware. In New Jersey, northern New Jersey is served by an organ procurement organization called the NJ Sharing Network.
What exactly does an OPO do?An organ procurement organization (OPO) serves as the bridge between acute care hospitals – where families are offered the opportunity to donate – and transplant centers where people are waiting for organs.
The OPO serving our region, Gift of Life, has a two-fold mission: to serve families who are making end-of-life decisions and to advocate for those who are waiting for a life-saving organ to become available. Gift of Life accomplishes this mission in several ways, and the process begins with education. To help increase the awareness of the critical need for organ and tissue donation and dispel the myths and misinformation that keeps people from saying “yes” to donation, it provides ongoing public and professional education.
In addition to offering critical education, Gift of Life coordinates the organ donation and transplantation process by providing evaluations at acute care hospitals that determine whether or not donation is an option. When donation is an option – which occurs less than two percent of the time – it partners with hospital staff to discuss the donation opportunity to the family.
If the family says “yes” to donation, Gift of Life adds the donor’s information into Unet and then contacts the transplant centers whose patients are on the list generated for that specific organ donor. Once a recipient has been identified, it manages the entire organ recovery process including the transportation for all of the transplant teams – which can be up to seven different teams, and the surgical recovery of specific tissues and organs the family has donated. If you’re interested in learning more about the organ donation process, this video gives some additional information.
The work of Gift of Life Donor Program continues after donation takes place. Through the organization’s family support services, donor family and recipient letters are coordinated and donor families are offered free counseling to support them through the first year after donation. In addition, ongoing support is provided through special events, such as the Annual Donor Family Recognition ceremony.