Christy Leek

United Network of Organ Sharing (UNOS)

The UNOS mission is to advance organ availability and transplantation to support patients through education, technology and policy development (UNOS, 2015). There is 122,571 people awaiting a lifesaving transplant (UNOS, 2015).
UNOS has a computerized system which stores vital information about each patient who is in need of a transplant, and matches all donor organs with someone on the waitlist. The system works every day for 24 hours a day. It does not take a day off for any reason. When a deceased donor organ becomes available then the UNOS computerized system will go through every single person that needs that particular organ and rank them to see who is suitable to receive it. There is no number ranking with UNOS. The system will screen patients by using the following criteria to match the donor organ, survival benefit, blood type, height, weight and other medical factor as well as wait time on the transplant list, this system is used for all organs. The other factor that is taken into consideration is the size of the organ and if it will fit nicely in the patient. The patients who rank highest on this list are usually the ones that need it urgently. Pediatrics candidates usually do better with other children’s organs and they have a unique scoring system that it goes through to match the donor organ with the patient. Organs are always offered other children’s organs first, if they don’t find a child to match then they will look at adults. Each donated organ has their own special methods to keep them viable between the times the organ is taken to the actual transplantation time. Kidney has 24-36 hours, Pancreas has 12-18 hours, and Liver 8-12 hours, and Heart & Lung has 4-6 hours. With the varied time the system will also take into consideration the distance where the organ is at and where the receiving patient is at as well. There are 58 local donor service areas and 11 UNOS regions in the US that are used.
The very first human organ to be transplanted successfully was the kidney and that was in 1954. Liver, heart and pancreas transplants were successfully performed by the late 1960s, while lung and intestinal organ transplant procedures were begun in the 1980s (UNOS, 2015). He potential of organ rejection limited the number of transplants until the 1980’s.
UNOS was incorporated as an independent, non-profit organization March 21, 1984. Also in 1984, the National Organ Transplant Act (NOTA) called for an Organ Procurement and Transplantation Network (OPTN) to be created and run by a private, non-profit organization under federal contract. The federal Final Rule provides a regulatory framework for the structure and operation of the OPTN (UNOS, 2015). UNOS was awarded the national OPTN contract in 1986 and continues as the only organization to ever operate the OPTN. Here is a list of highlights to show how UNOS and organ transplantation have grown through the years:
Date Event
1954 First successful kidney transplant performed.
1966 First simultaneous kidney/pancreas transplant performed.
1967 First successful liver transplant performed.
1968 First successful isolated pancreas transplant performed. First successful heart transplant performed. The Southeast Organ Procurement Foundation (SEOPF) is formed as a membership and scientific organization for transplant professionals.
1977 SEOPF implements the first computer-based organ matching system, dubbed the “United Network for Organ Sharing.”
1981 First successful heart-lung transplant performed.
1982 SEOPF establishes the Kidney Center, the predecessor of the UNOS Organ Center, for round-the-clock assistance in placing donated organs.
1983 First successful single-lung transplant performed. Cyclosporine, the first of a number of drugs that effectively treat organ rejection by suppressing the human immune system, introduced.
1984 National Organ Transplant Act (NOTA) passed. United Network for Organ Sharing (UNOS) separates from SEOPF and is incorporated as a non-profit member organization.
1986 First successful double-lung transplant performed. UNOS receives the initial federal contract to operate the Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients.
1987 First successful intestinal transplant performed. UNOS begins collecting medical data on donor and transplant recipients.
1988 First split-liver transplant performed.
1989 First successful living donor liver transplant performed.
1990 First successful living donor lung transplant performed.
1992 UNOS helps found Donate Life America to build public support for organ donation. UNOS prepares first-ever comprehensive report on transplant survival rates for all active U.S. transplant centers.
1995 UNOS launches its first Web site for all users with an interest in transplantation.
1996 UNOS creates Tiedi, a new application that collect data electronically and eliminates the need for mailing paper forms to the OPTN.
1998 First successful adult-to-adult living donor liver transplant performed.
1999 UNOS launches UNetsm, a secure, Internet-based transplant information database system for all organ matching and management of transplant data.
2000 U.S. Department of Health and Human Services publishes Final Rule (federal regulation) for the operation of the OPTN.
2001 For the first time, the total of living organ donors for the year (6,528) exceeds the number of deceased organ donors (6,081).
2006 UNOS launches DonorNetsm, a secure, Internet-based system in which organ procurement coordinators send out offers of newly donated organs to transplant hospitals with compatible candidates.
2014 Vascularized composite allographs (VCAs) is added to the definition of organs covered by federal regulation (the OPTN Final Rule) and legislation (the National Organ Transplant Act). The designation went into effect on July 3, 2014(UNOS, 2015).
What is deceased donation? It starts with you deciding if when you pass if you want to donate any of your organs. Here are some basic steps that happen in donation from deceased donors: EMS will begin life saving measures at the scene, during transport they call the ER and update them on the patient’s status. When the patient arrives at the ER the doctors and nurse will evaluate the injuries and continue life saving measures to help the heart keep beating. Once they get a patient stabilized then special test will be performed to see how much damage has been done to the brain and organs. If the doctors determine the patient is brain dead, meaning there was a loss of blood flow to the entire brain, then the body will continue to be supported by artificial means. If the patient wanted to donate their organs the then special medical team from the organ procurement organization will go the hospital the patient is at to determine if indeed their organs are suitable for donation. If they decide the organs are good for donation then the physician will speak to the family for consent to donate. If the patient did not sign up on the states donation registry, usually done at the time you get your driver’s license, then it will be up to the family members to decide. The doctors and the OPO team will always work together as a team to support the family and honor the patient’s wishes. Once consent is given then the organ recovery process will begin. No matter what the patient and their families are always treated with the utmost respect and honor throughout the whole process. They also let the families and funeral homes know that an open casket is still possible after donation. The best part I think myself is that the OPO still continues to provide support to donor families such as sending a letter to let the families know which organs were donated, bereavement counseling and even memorial events. If donor families and recipients want to meet or contact one another then the OPO and transplant programs have specific guidelines for that as well.
What is living donation? Living donation is when relatives, friends and even people who want to remain anonymous can donate. In fact, nearly 5,000 transplants were made possible in 2014 by living donors (UNOS, 2015). Who can donate? Any person 18 years of age and older who are in good physical and mental health. There are some medical conditions that can prevent donating living kidney and they are high blood pressure, diabetes, cancer, HIV, hepatitis, acute infections or a psychiatric conditions requiring treatment. If this is something you are interested in doing and if you don’t know of anyone that needs a kidney then you can do one of two things, visit the OPTN member directory for a list of transplant centers to contact or call the United Network for Organ Sharing patient service line at 1-888-894-6361. When you contact a transplant center you will first be asked for your consent and then begin a basic medical screening to see if you are a possible donor. The kidney is the most commonly transplanted organ from a living donor. One entire kidney is removed and transplanted. Living liver donation, where a segment of the donor’s liver is transplanted, occurs less often, and the donor is usually related to the recipient. Also, in rare cases, a segment of organs such as lung, intestine or pancreas can be transplanted from a living donor (UNOS, 2015).
There are three ways to donate, they are direct donation, altruistic donation and paired donation. Direct donation is where the donor names a specific person to receive the donation. The donor can be anyone they are a match with. Altruistic donation is where the donor does not name a specific person. Instead they match the pair based on medical compatibility. Then theirs paired donation or exchange which involves two pairs of living kidney donors and two transplant candidates. Basically the two transplant recipients will trade donors that match them. Sometimes this exchange can involve more than two each.
I hope I have given you a better understanding of transplant. It is truly a rewarding gift to donate your organs to another person in need. It is something I hope that more people will consider doing for another person. Remember you can help save a life!!

BIBLIOGRAPHY https://www.unos.org/ http://www.webmd.com/a-to-z-guides/organ-transplant-donor-information

http://www.americantransplantfoundation.org/

http://donatelife.net/understanding-donation/learn-the-facts/