United Network for Organ Sharing

Located in Richmond, Virginia, the United Network for Organ Sharing (UNOS) is a non-profit, scientific and educational organization that administers the only Organ Procurement and Transplantation Network (OPTN) in the United States, established (42 U.S.C. § 274) by the U.S. Congress in 1984. The organization's headquarters is situated near the intersection of Interstates 95 and 64 in the Virginia BioTechnology Research Park.

UNOS is involved in many aspects of the organ transplant and donation process:

• Managing the national transplant waiting list, matching donors to recipients 24 hours a day, 365 days a year.
• Maintaining the database that contains all organ transplant data for every transplant event that occurs in the U.S.
• Bringing together members to develop policies that make the best use of the limited supply of organs and give all patients a fair chance at receiving the organ they need, regardless of age, sex, ethnicity, religion, lifestyle or financial/social status.
• Monitoring every organ match to ensure organ allocation policies are followed.
• Providing assistance to patients, family members and friends.
• Educating transplant professionals about their important role in the donation and transplant processes.
• Educating the public about the importance of organ donation.

UNOS was awarded the initial OPTN contract on September 30, 1986 and is the only organization to ever manage the OPTN. UNOS provides the OPTN with a functional, effective management system incorporating the Board of Directors, committees and regional membership to operate OPTN elements and activities.^[1]

In late December 2013, it was announced that UNOS had developed new policies and regulations governing the new field of hand and face transplants like it does standard organ transplants, giving more Americans who are disfigured by injury or illness a chance at reconstruction. In July 2014, government regulations go into effect making hand and face transplants subject to the same oversight by UNOS as heart or kidney transplants.^[2] The rules mean potential transplant recipients will be added to the UNOS network, for matching of donated hands and face tissue to ensure correct tissue type and compatibility for skin color, size, gender and age. Transplants and their outcomes will be tracked.^[3]

Regions

UNOS and OPTN operate by grouping states into several different regions throughout the country.^[4]

1. Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Eastern Vermont
2. Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, West Virginia, and the part of Northern Virginia in the Donation Service Area served by the Washington Regional Transplant Community (DCTC) Organ procurement organization.
3. Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi and Puerto Rico
4. Oklahoma and Texas
5. Arizona, California, Nevada, New Mexico and Utah
6. Alaska, Hawaii, Idaho, Montana, Oregon and Washington
7. Illinois, Minnesota, North Dakota, South Dakota and Wisconsin
8. Colorado, Iowa, Kansas, Missouri, Nebraska and Wyoming
9. New York and Western Vermont
10. Indiana, Michigan and Ohio
11. Kentucky, North Carolina, South Carolina, Tennessee and Virginia

Allocation

UNOS uses a set policy to remove as much subjectivity as possible from the process of matching organs with recipients (referred to as a "match run".)^[5][6] There are several factors that are involved, including, but not limited to:

• Age
• Ability of the patient to recover
• ABO (though very young recipients are often considered for ABO-incompatible listing.)
• Distance
• Height and weight
• Life support status
• Listing status
• Time on the waiting list

The individual criteria varies from one organ type to another. For example, with heart and lung transplantation, candidate recipients are given one of four status levels (1A - the highest level, 1B, 2, and 7).^[7] A matching born (i.e. not in utero) candidate of Status 1A within the donor region, of matching ABO type, and within 500 miles will be given the highest priority, with multiple matches being ranked by time on the waiting list.^[7] Each of those criteria will be progressively relaxed until a match is found.^[7]

Membership

UNOS has five classes of members, with varying levels of rights and obligations.^[4][8]

• Institutional members: Regional organ procurement organizations (such as Gift of Hope), hospitals that perform transplantation, or histocompatibility laboratories that serve the aforementioned hospitals.
• Medical/scientific members: Professional organizations whose membership serve the field of transplantation, such as the American Society of Transplant Surgeons or the American Academy of Pediatrics.
• Public organization members: Organizations that serve to support transplant donors, recipients, and their families, such as National Kidney Foundation or the American Diabetes Association, or hospitals that refer donors but do not themselves perform transplants.
• Business members: Companies that do business with two or more institutional members.
• Individual members: Current or former members of the UNOS Board of Directors; Members or family of transplant candidates, donors, recipients; or other individuals who are or were involved in the field of or regulation of organ donation and transplantation, including employees of institutional members.

References

1. UNOS
3. AP (26 December 2013). "UNOS To Oversee Hand, Face Transplants Like Organs". WeeklyTimes. Retrieved 26 December 2013.
4. United Network for Organ Sharing. (2012, December 13). Organ Procurement and Transplantation Network Bylaws. United Network for Organ Sharing. Retrieved from http://optn.transplant.hrsa.gov/ContentDocuments/OPTN_Bylaws.pdf
5. United Network for Organ Sharing. (2013, January 31). OPTN Policy 3.2 - Waiting List. United Network for Organ Sharing. Retrieved from http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp
6. United Network for Organ Sharing. (2013). OPTN Policy. Retrieved from http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp
7. United Network for Organ Sharing. (2013, January 31). OPTN Policy 3.7 - Allocation of Thoracic Organs. Retrieved from http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp
8. OPTN Member Directory. (n.d.). OPTN Member Directory. Organ Procurement and Transplantation Network. Retrieved May 1, 2013, from http://optn.transplant.hrsa.gov/members/search.asp

External links

• Official sites:
  • Main UNOS site.
  • Main OPTN site, with data reports and policies, operated by UNOS on behalf of the Health Resources and Services Administration.
  • Transplant Living, for post-transplant recipients and living donors.
  • Transplant Pro, for professionals in the transplantation field.
  • Center for Transplant System Excellence
  • UNOS Meeting Partners, an event-planning service for transplantation-related organizations, including UNOS itself.
  • National Donor Memorial
  • United for UNOS, which serves to facilitate UNOS community outreach.
• Scientific Registry of Transplant Recipients, related statistical site also operated for the HRSA.