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Opportunities for Organ Donor
Intervention Research


Organ donation has the power to save lives and improve health outcomes, but the growing number of patients awaiting organ transplantation far exceeds the number of organs available.

A report from the National Academies of Sciences, Engineering, and Medicine offers recommendations to improve organ donor intervention research, a new area of study aimed at increasing the number and enhancing the quality of organs available for transplantation.

Scroll down to learn about the time-critical steps involved in organ donation and transplantation and how organ donor intervention research helps maximize the gifts of donated organs.

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Learn about the time-critical steps involved in organ donation and transplantation and how organ donor intervention research helps maximize the gifts of donated organs.

Organ Donation Authorization

Authorizing organ donation can happen at any point during a person’s lifetime, or through family or a surrogate after death. Often, a person specifies his or her preference when obtaining or renewing a driver’s license at a state department of motor vehicles (DMV). Designations can also be made through state- or national-level organ donor registries.

Each donor has the potential to donate up to eight organs, which can be transplanted into eight or potentially even more recipients. Donors may specify how their organs will be used, including transplantation, research, or both.

While the number of donated organs has increased, current demand far outpaces supply.

About the Organ Donor Registries

  • In the United States, the most common occasion for a person to specify his or her preference to be an organ donor is at the time of obtaining or renewing a driver’s license.
  • There are 53 donor registries through DMV agencies in each of the 50 U.S. states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
  • Donate Life America also operates a donor registry at the national level.

Identifying and Listing Transplant Candidates

Because the demand for donor organs exceeds the supply, those who have been identified by their health care team as needing an organ transplant must be placed on a waiting list for the type(s) of organ they need.

In that process, health care professionals provide information on a range of factors (e.g., age of the donor, health factors) that will need to be considered in making transplant decisions. This would be the time that a potential recipient and the health care team would discuss organ donor intervention research and whether to be considered for a research organ.

The Organ Transplantation Gap

While the number of organs transplanted has increased in recent decades, the growth in patients awaiting an organ transplant has far outpaced the number of organs being transplanted.

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The Network of Services for Organ Donation and Transplantation

After determining death and verifying that organ donation has been authorized, efforts are made across the network of organ donation and transplantation organizations to preserve and recover the organs and to match them to the appropriate recipients.

These efforts are accomplished by a robust interdependent network of multidisciplinary, multi-institutional services that includes organ procurement organizations (OPOs), donor hospitals, transplantation programs and centers, and histocompatibility laboratories.

Donation Service Areas Are Geographically and Culturally Diverse

Across the United States, the Organ Procurement and Transplantation Network operates in units referred to as donation services areas (DSAs); each of which encompasses organ procurement organizations (OPOs), donor hospitals, transplantation programs and centers, and histocompatibility laboratories. An extensive national computerized network is used to match donated organs with potential recipients.

Donor Management

After an organ donor dies and authorization to donate is verified, the organ procurement organization and donor hospital implement donor management protocols. These procedures aim to maintain organs in the best possible condition by minimizing organ stress, damage, and dysfunction until the organs are recovered.

Such protocols include administering medicines, maintaining the deceased donor’s body at a particular temperature, and various other steps.

Organ Matching and Transplant Decision

When an organ becomes available and a potential recipient is identified through the waiting list matching process, the transplant team contacts the potential recipient with details about the organ, such as the age and health of the donor.

If the organ is part of a research study and the transplant candidate is willing to consider receiving a research organ, details about the research study would be provided so that the candidates can factor this information into their decision about whether to go forward with the transplantation.

To maintain the organ in optimal condition, the decision of whether to accept an organ needs to be made quickly—usually within 1 hour of receiving the offer and accessing the deceased donor’s information.

Preservation Time Varies By Type of Organ

Organ Donor Intervention Research

Organ donor intervention research tests and assesses medicines, devices, and donor management protocols with the goal of improving the quality of organs to be transplanted. This work can be done either before or after the organ is recovered from the donor but prior to transplantation.

Every year, some organs that are recovered for use in transplantation are later determined to be unsuitable for this purpose. This is often due to poor organ function, vascular damage, or organ trauma. Organ donor intervention research presents an opportunity to discover ways to improve organ quality and viability, increasing the number of organs suitable for transplantation.

Donor Intervention Research Helps Maximize Successful Transplants

The intent of organ donor intervention research is to identify interventions that can improve the quality and viability of transplantable organs. The research occurs during donor management and before a transplant. Information about the research in general would be provided to transplant candidates during their time on the waiting list, with details about the specific research study provided at the time the organ is offered to the candidate.

Transplantation and
Post-Transplant Follow-Up

If the transplant team determines that the organ is acceptable, and the potential recipient confirms he or she will accept the organ, the transplant moves forward. Transplantation is followed by a period of extensive follow-up care.

Conclusion

Despite scientific advances over the past several decades, some organs still may not be recovered, some recovered organs may not be transplanted, and some transplanted organs may not function adequately. There simply are not enough viable donated organs to meet existing demand.

Deceased organ donor intervention research has the potential to help address this growing need, honoring the gift of donated organs by fully using those organs to save and improve the quality of the lives of their recipients.

Read the full report and recommendations

The National Academies of Sciences, Engineering, and Medicine has developed a set of goals and recommendations to guide work on organ donor intervention research that can help enhance the quality and increase the quantity of organs that can be recovered from donors and transplanted.

Steps can be taken by a variety of stakeholders to:

  • Communicate about this research to the general public
  • Coordinate donor registries across state DMVS and other registries
  • Clarify state laws
  • Inform potential transplant recipients about their options regarding research organs
  • Establish centralized management and oversight of organ donor intervention research
  • Develop tools to track research outcomes