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AOPO Highlights Disturbing Crisis: Thousands of Kidney Patients who Died Waiting for Organs in 2023 Could Have Been Saved

Organ Procurement Organizations recovered 2X the kidneys needed for dying patients, but the organs went to waste; underscoring the rise in organ nonuse in the U.S.

McLean, VA. (Sept. 12, 2024) — The U.S. organ donation and transplantation system has witnessed 13 years of consecutive growth in donation. Organ procurement organizations (OPOs), federally designated non-profits that facilitate the donation process, are vital to ensuring every donation opportunity leads to lives saved.

OPOs educate communities about organ donation to increase registered donors, partner with hospitals to identify potential organ donors, provide compassionate care to families in their time of grief, support the clinical management and recovery of organs and work tirelessly to match organs with recipients whose lives depend on it. OPOs continue to advance practice and utilize innovations and technology to make more organs available.

Although organ donation is on the rise, transplant is not growing at the same rate.

Last year, more than 3,800 Americans died waiting for kidney transplants, despite the fact that our nation’s OPOs recovered more than double the number of organs that may have saved them. Those kidneys – 8,500 in total –were offered by OPOs to patients but declined by their transplant centers and ultimately not transplanted.

This concerning finding underscores a mounting national crisis: the sharp rise in the nonuse of transplantable organs that could save the lives of Americans dying on the waiting list. Currently, OPOs must offer an organ thousands of times a day to transplant programs in hopes they will accept it. Eventually, the organ becomes unviable and cannot be used.

The non-use of organs is a secondary loss for donor families, as OPOs recover precious organs from their loved one, only to inform the grieving family that the donated organs were not accepted for transplant.

Experts agree that solving the nonuse crisis is the single fastest way for the U.S. to save more lives through transplant.

Government data shows:

• • • In 2023, OPOs recovered over 43,000 organs from deceased donors for transplantation, marking 13 consecutive years of record growth and surpassing a goal set by the Centers for Medicare & Medicaid Services (CMS) to recover 41,000 organs by 2026.
    • 8,579 of the kidneys recovered by OPOs and offered to transplant patients were rejected by their transplant programs and ultimately became unviable and went unused. That represents over 28% of all kidneys recovered from deceased donors in 2023.
    • In the same year, 3,803 kidney patients on the national waitlist died despite the surplus of transplantable organs.
    • Those same 8,579 kidneys were offered by OPOs to transplant programs across the U.S. a total of 26,253,656 times before they became unviable and could not be used.
    • Overall, the nonuse rate of recovered kidneys has grown by 52% since 2016.

The data above directly contradicts testimony presented yesterday at a hearing of the Oversight and Investigations Subcommittee of the U.S. House Committee on Energy and Commerce that there are not enough organs available in the nation to save people dying on the waiting list.

“The Association of Organ Procurement Organizations (AOPO) has a professional, moral, and ethical duty to shine a light on this national crisis, which has gone unaddressed for far too long,” said Dorrie Dils, President of AOPO. “We urge lawmakers to reject the divisive rhetoric preventing our system and its regulators from working together. Instead, we must unite to finally solve organ nonuse so we can immediately make more organs available to Americans dying unnecessarily on the waiting list.”

Experts have identified multiple reasons transplant programs are rejecting organs, including lack of resources and adequate staffing to respond to the rising number of organs available. Government-funded research by the National Academies of Sciences, Engineering, and Medicine highlighted the existence of a “weekend effect,” in which organs recovered during weekends are significantly less likely to be used by transplant centers than organs recovered during weekdays. The same report noted that kidneys are transplanted at much higher rates in other developed countries, estimating that 62% of kidneys not used in the United States would have been successfully transplanted in France.

A 2019 study published in the Journal of the American Medical Association found that patients who die waiting for a kidney were offered a median of 16 kidneys that were ultimately transplanted into a patient lower on the wait list. Often the patients were unaware that the organs had been declined on their behalf.

Proposed solutions to nonuse – which are being informed and vetted by HRSA’s Expeditious Task Force – focus on ensuring transplant programs are equipped with the necessary resources, policies, and best practices to accept the ever-growing surplus of organs recovered by OPOs. Yet last week, HRSA stopped a critical pilot program of the Expeditious Task Force that would test strategies for reducing organ nonuse by transplant centers without jeopardizing transplant outcomes.

“Yesterday’s hearing falsely depicted the best transplant system in the world as failing, which is an insult to the thousands of Americans who work around the clock to make donation possible and the countless donor families who have given the ultimate gift to save others,” said Dils. “Continuing to promote this fallacy does nothing but tear our system apart and break public trust at a time when patients are relying on us to save their lives. AOPO calls upon HRSA to keep its focus on the good work of the Expeditious Task Force and allow the pilot to move forward as it is the best hope for saving more lives through transplantation today.”

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About the Association of Organ Procurement Organizations (AOPO)

The Association of Organ Procurement Organizations (AOPO) is the not-for-profit trade association leading the nation’s organ donation community to save and improve lives through organ, eye, and tissue donation. Founded in 1984, AOPO advances organ donation and transplantation by driving continual improvement of the donation process, collaborating with stakeholders, and sharing successful practices with its 48 member OPOs. AOPO envisions a future where every opportunity for donation results in lives saved. For more information, please visit www.aopo.org.