U.S. Organ Procurement Organizations Achieve Record Organs Recovered and Transplanted in 2024 Amid Policy Challenges

The U.S. organ donation and transplantation community achieved a historic milestone in 2024, with organ procurement organizations (OPOs) recovering over 45,000 organs which were successfully transplanted to save lives. This marks 14 consecutive years of nonstop growth in donation and reflects the dedication of OPOs, donors, donor families, and transplant professionals.

According to newly confirmed data from the Organ Procurement and Transplantation Network (OPTN), in 2024:

• • 45,217 organs from deceased donors were transplanted, saving 39,505 lives.
  • An average of 132 organ transplants were performed daily.
  • 16,989 Americans became deceased organ donors.
  • 34 OPOs recovered more donors in 2024 than in 2023.

Continuous Progress Through Innovation and Collaboration

OPOs have driven year-over-year success through advancements in medical science, strategic partnerships with transplant centers, and a commitment to reducing health disparities. These efforts are essential to achieve AOPO’s goal of 50,000 annual organs transplanted in 2026. However, despite OPOs’ progress towards this goal, federal policy misalignments continue to jeopardize the system’s ability to honor every donor and maximize the number of lives saved.

Policy Barriers Contributing to Organ Non-Use

The Centers for Medicare & Medicaid Services (CMS) mandates OPOs to increase the number of organs donated and transplanted, yet conflicting policies disincentivize transplant centers from accepting many of these recovered organs. As a result, a growing number of organs—particularly kidneys from older and medically complex donors—go unused. In 2024 alone, 9,266 kidneys were recovered but not transplanted, marking an 83% increase in kidney non-use over the past five years.

Based on OPTN data as of January 2025

One approach to mitigating non-use is initiating rescue pathways, also known as expedited placement. This emergency protocol allows OPOs to offer viable organs at risk of non-use to alternative transplant centers with compatible patients. Using rescue pathway allocation is a carefully considered practice, addressed in federal policy, and used in specific, medically necessary circumstances to reduce organ non-use and increase the chances of successful transplantation.

OPOs and transplant centers acknowledge this is not an ideal system and have advocated for improvements to the current allocation process for years. The rise in rescue pathway organ allocation is an unintended consequence of misaligned federal policies. It also reflects an evolving donation and transplantation system adapting to complex realities, such as longer transplant distances due to broader sharing and the volume and complexity of donors creating timing challenges.

AOPO is pleased the Health Resources and Services Administration (HRSA) recently renewed efforts to explore new rescue pathway policies and protocols. This is a step toward establishing a more equitable allocation system that reduces organ non-use and minimizes the need for OPOs to rely on rescue pathways to save lives. We encourage federal agencies and contractors to use the National Academies of Science, Engineering, and Medicine (NASEM) report as a blueprint for additional solutions to advance the organ donation and transplant system.

At the same time, CMS policies set to take effect in 2026 threaten the operational stability of the nation’s OPOs. These policies could lead to the decertification of up to 42% of OPOs, risking severe disruption to the donation and transplant system. Without careful coordination and enhancements to existing frameworks for evaluating OPO performance, these changes could not only compromise access to organ transplantation but also jeopardize the heroic intent of donors and their families.

OPOs Leading Systemwide Collaboration

While federal intervention is crucial, OPOs are not waiting for policy change to address these challenges. Over the past year, OPOs facilitated eleven Transplant Growth Collaborations, bringing together high-performing transplant centers and OPOs to share successful practices, address system inefficiencies, and develop solutions to reduce organ non-use.

The Urgent Need for Policy Reform

AOPO is calling on government agencies and lawmakers to take immediate action to align federal policies, ensuring both OPOs and transplant centers are able to maximize organ utilization while upholding fairness in allocation. The impact of inaction is clear: over 104,000 patients currently await lifesaving transplants, and each organ which goes unused represents a missed opportunity to save lives.

Together, we can ensure that every donor’s gift is honored and that every viable organ is transplanted to save lives.

Thank you,
Steve Miller, MBA, CAE
AOPO CEO