The United Network for Organ Sharing (UNOS) is an American organization which oversees organ donations across the United States. The use of a single organization to monitor organ transplants streamlines the process and creates a unified national list which keeps transplantation fair for all patients in the United States. UNOS also administers the Organ Procurement and Transplantation Network (OPTN), a national network established by the American government. Organ procurement and transplant centers must join OPTN to receive federal assistance such as Medicare.
In 1968, the Southeast Organ Procurement Foundation was established to start coordinating organ donation; in 1977, the group created UNOS, an organ matching system and rubric which was designed to create a unified scale for patients, along with a list, to ensure that patients with the most need got organs first. In 1984, UNOS split from its parent organization and became its own entity, and it was awarded the OPTN contract in 1986.
When a doctor determines that his or her patient needs an organ transplant, the doctor brings the patient's case to the hospital's transplant committee, which determines whether or not the patient is eligible for a UNOS listing. By being listed in UNOS, the patient is eligible for organs which become available anywhere in the United States. When the patient is listed, data like his or her bloodtype and medical history is entered, along with a score which indicates need.
A number of factors are considered in organ matching. Blood type is an obvious concern, as well as proximity; some organs do not travel well, so although someone might have a demonstrated need, he or she might be too far away for the transplant to be viable. A complex computer system is used to find UNOS matches to keep things as fair as possible. When UNOS finds a donor match, the hospital in charge of the top-ranked patient for the organ in question is notified. The hospital can accept the organ, or decline it and allow it to pass to the next person on the list.
Patients can also bypass the UNOS system for living organ donation. For example, a friend of a liver transplant patient might agree to donate part of his or her liver to the patient. This private arrangement is not governed by UNOS, since the donor is making a personal choice. Families of deceased donors can also divert organs to specific recipients.
Typically, around 100,000 Americans are waiting for organs at any given time. UNOS is able to meet only a fraction of the need, although this streamlined national system certainly ensures that the maximum number of patients in need get organs. Individuals can help make up the shortfall by registering as organ donors and indicating their desire to their families.