The Background of UNOS (United Network for Organ Sharing)
The system of organ donation early in the era of transplantation was focused on local networks. The receipt of available organs was limited to those in an area hospital’s network. As the process of organ transplantation became more advanced, and subsequently more of an option for those in need of life saving treatments, the necessity for a system to effectively track organ donors with recipients became necessary. UNOS (United Network for Organ Sharing) fulfills that need.
The Southeastern Regional Organ Procurement Program was established as a kidney-sharing system in 1969 to increase the efficiency of organ placement (https://www.medscape.com/viewarticle/436539_5). Later named the Southeastern Organ Procurement Foundation, it became the central depository for data regarding all types of solid organ transplantation in 1977, with the establishment of a computerized database that housed that information. That database was called UNOS. Due to more transplantation resources become available, the U.S. Congress passed the National Organ Transplant Act in 1984, which began the Organ Procurement and Transplantation Network (OPTN) to maintain a national registry for organ matching (https://optn.transplant.hrsa.gov/governance/about-the-optn/history-nota/). UNOS was awarded the contract in 1986 to develop the OPTN, and has operated that network ever since.
In maintaining OPTN, UNOS manages the national transplant waiting list for the United States. This organ sharing system maximizes the efficient use of deceased organs through equitable and timely allocation. UNOS also collects, stores, analyzes and publishes data pertaining to every transplant event that occurs in the U.S. (https://unos.org).
To support the organization and its efforts to organize and maintain the organ transplant network nationwide, UNOS bases its operations on three tenents: Education, Technology, and Policy.
For patients who need, or have received, transplants, UNOS fills those individuals’ quest for knowledge through education via the Transplant Living website (https://transplantliving.org/) which offers information about living donations, patient brochures that enable the public to understand the organ transplant process, and education to assist and inform transplant professionals of industry matters.
Technology is an integral component to maintain the nation’s organ transplant network. UNOS’ electronic network, UNet, provides the vehicle for transplant professionals to register candidates onto the national network, and match them with donor organs as they become available. In addition, the matching process is enhanced with the application, DonorNet. While UNet enables candidate registration and matching, DonorNet increases efficiency within the system, as it records information about donor offers, and transmits it to transplant hospitals with compatible transplant candidates.
Finally, policy development that UNOS undertakes can be seen as the underpinning to its operations. A 42-member Board of Directors addresses issues and develops solutions for matters involving patient and donor family issues, medical issues specific to various transplantable organs, and technical aspects of organ recovery and matching. Further, ethical principles unique to the industry are identified, discussed and addressed. Once issues are identified, proposals are drafted, and feedback is received. Subsequently, the Board of Directors vote on the proposals, and if passed, policies and changes are implemented and communicated to the transplant community.
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Topic for Saturday, January 20th posting – Transplantation Firsts, Part 1 – First Kidney Transplants
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