Producing Organ Donors

Organ transplantation is one of the greatest technological achievements of modern medicine, but the ability of patients to benefit from transplantation is limited by shortages of transplantable organs. The median waiting time for patients placed on the kidney transplant waiting list is over three years. Median waiting times for hearts and livers are seven months and two years, respectively. From 1995 to 2005, the number of patients placed on the waiting list for organ transplants grew at an annualized rate of 4 percent per year. As a result of the growth in the demand for organs, many observers have questioned whether the current system is capable of providing enough transplantable organs. Transplant physicians and policymakers are seriously debating proposals to pay donors and their families and to change the legal regime governing the process of obtaining consent to donation. This paper provides an overview of the rules and practices that govern the organ procurement system and reviews proposals to increase donation rates, with a focus on deceased donors.