Organ Donation 101: Here’s What to Know

December 4, 2025

The article explores the U.S. organ transplant system through ten key questions, using the story of Micah Clayborne, a teenager who received a life-saving heart transplant after being diagnosed with Danon disease. While 2024 saw a record 48,000 organ transplants, over 105,000 Americans remain on waiting lists, with approximately 17 people dying daily while awaiting organs. The piece examines how the system operates through nonprofit organ procurement organizations (OPOs) and the United Network for Organ Sharing (UNOS), which manages allocation through a computerized matching system.

Who is affected

Micah Clayborne (15-year-old heart transplant recipient)
Over 105,000 Americans currently on the national transplant waiting list
Approximately 92,000 people waiting specifically for kidney transplants
Black Americans (roughly 32,000 waiting for kidney transplants, representing the second largest demographic group)
Approximately 17 people who die daily waiting for transplants
170 million registered organ donors in the United States
Black and Brown communities experiencing mistrust toward the organ donation system

What action is being taken

The Centers for Medicare & Medicaid Services (CMS) is evaluating and ranking 54 organ procurement organizations in a recertification cycle ending July 31, 2026
The transplant system is transitioning from designated service areas (DSAs) to a 250 nautical mile circle allocation system around donor hospitals
UNOS computer systems are actively filtering and matching donors with recipients based on medical criteria
Organ procurement organizations are recovering organs from deceased donors and sharing medical information with transplant teams
Experts are continually evaluating feedback and data toward improving disparities in the system

Why it matters

Despite record-breaking transplant numbers, the critical organ shortage means thousands of Americans face life-or-death waits, with nearly two dozen people dying each day. The system's complexity and geographic allocation methods can create inequities, particularly affecting Black Americans who represent a disproportionately large portion of those waiting for transplants. Mistrust within Black and Brown communities—stemming from myths about medical treatment of registered donors—further compounds access barriers. The ongoing reforms to allocation systems and OPO oversight represent crucial opportunities to address these disparities and save more lives, making understanding of how the system works essential for improving equity and outcomes.

What's next

The current OPO recertification cycle will conclude on July 31, 2026, when CMS will determine which organizations maintain certification based on performance rankings.

Read full article from source: Michigan Chronicle