United Network for Organ Sharing

United Network for Organ Sharing
source
Name	United Network for Organ Sharing
Type	Nonprofit organization
Founded	1984
Headquarters	Richmond, Virginia
Area served	United States

Contents

United Network for Organ Sharing The United Network for Organ Sharing (UNOS) is the private nonprofit that administers the Organ Procurement and Transplantation Network under contract with the United States Department of Health and Human Services, operating the national organ transplant waiting list and matching system. It coordinates donor hospitals, Organ Procurement Organization, transplant centers such as Mayo Clinic, Cleveland Clinic, and Massachusetts General Hospital and liaises with regulatory entities including the Centers for Medicare & Medicaid Services, Food and Drug Administration, and the Institute of Medicine. UNOS develops allocation policy in consultation with stakeholders like the American Medical Association, American Society of Transplant Surgeons, American Society of Transplantation, and patient advocacy groups including American Liver Foundation and National Kidney Foundation.

History

The organization was formed after the passage of the National Organ Transplant Act of 1984 and the establishment of the Organ Procurement and Transplantation Network, with initial operations influenced by early transplantation pioneers at institutions such as Johns Hopkins Hospital, University of Pittsburgh Medical Center, and Stanford Health Care. Throughout the 1990s and 2000s UNOS adapted to advances in immunology from work at National Institutes of Health laboratories and policy recommendations from the Institute of Medicine and President's Council on Bioethics. Major policy milestones included revisions following landmark cases and guidance from courts such as the United States Court of Appeals for the District of Columbia Circuit and reports by Government Accountability Office. In the 2010s technological upgrades incorporated models from the Scientific Registry of Transplant Recipients and collaborations with academic centers including Harvard Medical School and University of California, San Francisco.

UNOS is governed by a volunteer board of directors drawing trustees from transplant centers, Organ Procurement Organizations, organ donor families, and transplant recipients, with executive leadership historically recruited from health systems like Kaiser Permanente and academic medicine leaders from Yale School of Medicine. Advisory committees include clinical and policy panels composed of representatives from the American College of Surgeons, American Heart Association, American Association for the Study of Liver Diseases, and professional societies such as the Pediatric Transplantation Society and Transplantation Society. Contractual oversight is performed by the Health Resources and Services Administration within Department of Health and Human Services, with reporting intersections involving the Office of Inspector General (United States). Financial and nonprofit compliance aligns with filings reviewed by entities including the Internal Revenue Service and audited by major firms that serve hospitals like Johns Hopkins Medicine.

UNOS operates the match run algorithm that pairs donor organs with recipients on the national waiting list, integrating clinical criteria developed with experts from Johns Hopkins School of Medicine, Stanford University School of Medicine, Duke University Hospital, and specialty organizations such as the American Society of Transplant Surgeons and International Society for Heart and Lung Transplantation. Allocation policies account for factors informed by research from the Scientific Registry of Transplant Recipients, the National Institutes of Health, and transplant registries maintained by academic centers including Cedars-Sinai Medical Center and Mount Sinai Hospital. System changes have responded to legal rulings and federal guidance from the Supreme Court of the United States and the Department of Justice, and to public health considerations signaled by the Centers for Disease Control and Prevention during infectious disease outbreaks. Technology implementations use database and software practices aligned with standards from National Institute of Standards and Technology and health IT partnerships with vendors used by Veterans Health Administration facilities.

UNOS supports organ procurement through coordination with local Organ Procurement Organizations such as LifeGift, New England Donor Services, and OneLegacy, and provides training and certification programs akin to continuing education at institutions like American Board of Surgery-certified programs. Public education and donor registration campaigns have partnered with nonprofits including Donate Life America and media organizations such as American Broadcasting Company affiliates and National Public Radio. Quality improvement and case review programs involve collaboration with hospitals like Children's Hospital of Philadelphia and research centers at University of Pennsylvania Perelman School of Medicine, with initiatives addressing disparities identified by scholars at Columbia University and University of Michigan.

UNOS has faced scrutiny over allocation policy disputes brought by transplant centers and patient advocacy groups, legal challenges guided by counsel experienced with the Federal Trade Commission and litigated in courts including the United States District Court for the Eastern District of Virginia. Criticisms from media outlets such as The New York Times and Washington Post and investigations by the Government Accountability Office spurred policy reviews and technical audits, while whistleblower concerns have involved oversight inquiries by the Office of Inspector General (United States). High-profile cases involving allocation outcomes prompted debates among stakeholders including the American Medical Association, ethicists from Georgetown University and University of Chicago, and legislatures at the United States Congress.

UNOS maintains comprehensive data used by researchers at the National Institutes of Health, academic institutions like Yale School of Medicine, University of California, San Francisco, Johns Hopkins University, and registries such as the Scientific Registry of Transplant Recipients to study outcomes, disparities, and policy impacts. Quality improvement collaborations include projects with the Centers for Medicare & Medicaid Services, the Institute for Healthcare Improvement, and specialty societies such as the American Society of Transplantation and International Society for Heart and Lung Transplantation, producing peer-reviewed analyses in journals linked to American Journal of Transplantation and The Lancet. Data governance and privacy practices align with standards promoted by the National Institutes of Health and National Institute of Standards and Technology, and support translational studies conducted by centers including Mayo Clinic and Cleveland Clinic.

Category:Medical and health organizations based in the United States