Select Page



New lung allocation policy in effect

Effective March 9, 2023, the Organ Procurement and Transplantation Network (OPTN) launched a new policy for matching lung transplant candidates with organs from deceased donors. It is projected to decrease deaths among waitlisted patients and provide more lung transplants for the most medically urgent candidates. United Network for Organ Sharing (UNOS) serves as the OPTN under federal contract.

The new policy is the first to utilize an approach known as continuous distribution. Under the new framework, all of the factors used in the organ match are included in a single, weighted score calculated for each lung transplant candidate and each lung offer from a donor. Under the previous lung allocation policy, a set of different matching classifications (such as donor compatibility, candidate urgency, and distance from donor hospital to transplant hospital) were determined individually and then applied in a sequence to decide the order of lung matches.

“This innovative new system will be more equitable and patient-focused,” said Marie Budev, D.O., M.P.H., chair of the OPTN Lung Transplantation Committee. “It will erase groups or classifications and will consider factors that define a candidate’s unique need for an organ all at the same time.”

For more information

Statistical modeling of the new policy suggests it will not only reduce the number of lung candidates who die awaiting a lung transplant, but it will increase transplant access for a number of candidates. This includes candidates who are:

  • The most medically urgent
  • Younger than age 18
  • A prior living organ donor
  • More likely to have immune system rejection of many organs
  • Short in stature
  • Expected to live longer after a transplant

UNOS will actively monitor the performance and effects of the policy and, if needed, make recommendations for any additional measures to help the system meet expected goals.

New composite score for lung matches

All lung transplant candidates will now receive a lung composite allocation score (lung CAS). It replaces the lung allocation score (LAS) previously calculated for candidates age 12 and older. (For lung candidates younger than age 12, the two existing priority rankings will be included within their lung CAS.)

Within the overall lung CAS, candidates receive varying numbers of points based on a set of different attributes. The attributes are weighted, meaning they have different maximum point values to reflect how much they contribute to the total score. The categories of attributes, with the maximum point values for each, include:

  • Candidate medical urgency (maximum 25 points)
  • Likelihood of recipient survival over five years post-transplant (maximum 25 points)
  • Potential biological challenges in matching, such as the candidate’s blood type, height or immune sensitivity (maximum 15 points)
  • Whether the candidate was younger than age 18 when listed for a transplant (20 points)
  • Whether the candidate was a prior living organ donor (five points)

A final category of attributes, worth as many as 10 points, is determined by each lung offer from a donor who is a potential match for the candidate. More points will be assigned to matches where the donor hospital and the candidates’ transplant hospital are closer to one another, and where the logistics of preserving and transporting the lungs between the two hospitals are more likely to result in a successful transplant. Because this portion of the lung CAS may be different for every organ offer, the total score will not remain the same for all patients and all matches.

Although the maximum lung CAS score is 100, no candidate would ever have a score that high because no one could meet all the criteria and the maximum point values for each. Many candidates will likely have lung CAS scores of 20 to 22 before additional points are assessed for the individual donor match. A few candidates may have scores as high as 45, before points are added for the efficiency of the donor match.

Policy reflects extensive input, prioritization and optimization analysis, simulation modeling

The Lung Transplantation Committee developed the policy after extensive input from the organ donation and transplantation community and from people who need or have received a lung transplant. The committee initially published a concept paper in 2019 to foster additional recommendations to develop the policy criteria. For the first time, UNOS used a values prioritization exercise to learn how stakeholders and the public thought the various allocation factors should be weighted relative to one another. Nearly 200 individuals representing a broad range of experiences and perspectives took part in the exercise. In addition, researchers from the Massachusetts Institute of Technology (MIT) applied artificial intelligence and machine learning to advise the committee on the potential gains and tradeoffs that specific weights to the various factors would have on other policy goals.

The Scientific Registry of Transplant Recipients (SRTR) performed two rounds of simulation modeling, one to assess potential effects of the committee’s initial recommendations and a second to highlight likely outcomes of the committee’s proposed policy for public comment. The OPTN Board of Directors unanimously approved the policy at its December 2021 meeting.

Related reading on

hi2022: A year of livesaving milestones: Exceeded 42,800 transplants*; Surpassed 25,000 kidney transplants for the first time*; Also set all-time records for liver, heart and lung transplants*. *Based on OPTN data as of Jan. 9, 2023. Data subject to change based on future data submission or correction

2022 organ transplants again set annual records

2022 organ transplants again set annual records

Organ donation from deceased donors continues 12-year record-setting trend

In brief:

  • More than 42,800 organ transplants performed in 2022, again setting annual record
  • Total kidney transplants exceeded 25,000 for the first year ever
  • Annual records also set for liver, heart and lung transplants
  • Deceased donation continues 12-year record trend

In 2022, 42,887 organ transplants were performed in the United States, an increase of 3.7 percent over 2021 and a new annual record, according to preliminary data from United Network for Organ Sharing (UNOS), which serves as the national Organ Procurement and Transplantation Network under federal contract.

Also for the first year ever, more than 25,000 kidney transplants were performed in the United States. The total of 25,498 marked an increase of 3.4 percent over 2021. In addition, annual records were set for liver (9,528), heart (4,111) and lung (2,692) transplants.

“In a year that we commemorated one million transplants performed nationwide, we are glad to mark accelerated progress toward the next million,” said Jerry McCauley, M.D., M.P.H., president of the UNOS Board of Directors. ”We thank all the living and deceased organ donors, as well as the loved ones of deceased donors, who have provided a lifesaving gift. We also honor all the clinicians and professionals involved in organ donation and transplantation, who work tirelessly to make as many transplants happen as possible every day.

“We also should rededicate ourselves to meeting the continuing need,” added Dr. McCauley. “Many people still wait anxiously for a life-giving transplant. We must continue to improve in our capabilities to give them this vital opportunity by ensuring use of as many donated organs as possible.”

Deceased donation trends

A total of 14,903 people became deceased organ donors nationwide in 2022, representing the twelfth consecutive record year for deceased donation and an increase of 7.5 percent over 2021.

As the medical criteria for deceased organ donation continue to broaden based on favorable clinical experience, increasing proportions of donors come from less traditional categories of eligibility. In 2022, 4,776 people donated after circulatory death (DCD donors) as opposed to brain death, representing an increase of nearly 14 percent over the 2021 total. There were 5,789 deceased donors aged 50 or older, the first time there have been more than 5,000 donors of that age range in a single year.

Increases in donation occurred in many areas throughout the nation. Of 57 organ procurement organizations (OPOs)*, 42 (73.6 percent) experienced an increase in donation over their 2021 total. Two-thirds of all OPOs (38 total) set all-time records in 2022 for donors recovered in a single year.

Living donation trends

A total of 6,466 people became living organ donors in 2022, slightly fewer than in 2021. Living organ donation has varied considerably over the last several years, reflecting various trends in transplant need and the circumstances where living donation is an option. The all-time record of 7,389 in 2019 was followed by a decrease to 5,726 in 2020, due to effects of the COVID-19 pandemic.

While most living donors provide a kidney for transplant, an increasing number of people donate a segment of their liver. In 2022, there were 603 liver transplants involving living donors, an annual record and an increase of nearly 6 percent above the total in 2021.

*Note: Throughout 2022, there were 57 organ procurement organizations (OPOs) nationwide. Due to an OPO merger that took place in January 2023, there are now 56 total organizations, and data beginning in 2023 will reflect the new total.


Medicare Part B benefit available for kidney recipients

Medicare Part B Immunosuppressive Drug Benefit

As UNOS Ambassadors, we wanted to let you know about a new benefit available to eligible kidney recipients through Medicare Part B. This is a benefit that has been in the works for years, and we wanted to provide some important information as you continue on your individual transplant journeys.

The Centers for Medicaid and Medicare Services (CMS) recently announced a drug benefit for eligible kidney recipients that would help cover the costs of immunosuppressive medications.


If you are 36 months post kidney transplant, receive Medicare benefits because of End Stage Renal Disease (ESRD), and are not enrolled in other healthcare coverage, you may be eligible for the Medicare Part B Immunosuppressive Drug benefit.

Dates to Remember

Eligible individuals can enroll in this new benefit at any time, and those who terminated their coverage can re-enroll at any time. For those who enroll by December 31, 2022, coverage will begin January 1, 2023. If you enroll after December 31, 2022, your coverage will begin the following month.

How to Apply

If you believe you or someone you know is eligible for this benefit, contact the Social Security Administration at 1-877-465-0355 or download and complete the form CMS-10798.

The completed form should be mailed to:
Social Security Administration
Office of Central Operations
PO Box 32914
Baltimore, Maryland 21298-2703

We hope you find this information helpful, and we encourage you to contact your healthcare provider or transplant team for with additional questions.


New Medicare benefit available for kidney recipients

Starting Jan. 1, 2023, a new Medicare benefit is available for certain kidney recipients to help cover the costs of immunosuppressive medications. This benefit is for transplant recipients who have Medicare because of End Stage Renal Disease (ESRD), and who received a transplant more than 36 months ago. General enrollment for Medicare plans ended on Dec. 7, however eligible individuals enroll in this new benefit at any time.

Read more about Medicare B immunosuppressive drug benefit eligibility, and how to enroll at


Patient information on disaster relief and assistance

UNOS, in its role as the Organ Procurement and Transplantation Network (OPTN), is dedicated to providing assistance to member institutions, transplant candidates and potential living donors in the event of a natural disaster affecting long-term services of transplant centers.

UNOS is in contact with all member transplant facilities nationwide. In case of significant and potential long-term disruption of service at one or more centers, we will provide any needed updates through this website. The Organ Center can assist transplant hospitals and organ procurement organizations as needed with organ placement or management of key donor or candidate data, in order to provide continuity of essential services.

Transplant institutions should maintain disaster recovery plans that address their individual facility’s needs and circumstances. This includes mechanisms for communicating with transplant candidates and potential living donors.

As UNOS monitors the impact, we are diligently working with transplant hospitals to stay up-to-date on the evolving situation and its effect on patients.

For transplant candidates experiencing a disruption, your transplant hospital is the best contact regarding interim care, your status, appointment schedules, and availability of critical services.

For help in contacting your transplant hospital, you may call our toll-free Patient Services line at (888) 894-6361. Patient Services is staffed from 8:30 a.m. to 4 p.m. ET, Monday through Friday.


U.S. reaches historic milestone of 1 million transplants

U.S. reaches historic milestone of 1 million transplants

In a historic milestone, the U.S. has achieved its 1 millionth organ transplant, more than any other country in the world.

Thanks to a growing public commitment to organ donation, and thanks to the collective skill and dedication of thousands of organ donation and transplant professionals, the nation continues its record-setting trend of increases each year in transplantation:

  • In 2021, for the first time, more than 40,000 transplants took place, a total likely to be repeated if not surpassed in 2022.
  • In each of the past 11 years, new annual records have been set in the number of deceased donors nationwide.
  • Half of all the transplants ever performed in the U.S. have taken place in just the past 15 years.
  • More than 400,000 people are alive today with a functioning transplant.

The 1 million milestone demonstrates a powerful trend of system-wide increases, a success made possible by the ongoing expansion of more equitable organ allocation policies, an increasing focus on non-traditional donors, collaborative efforts to increase donation, the continuous evolution of organ preservation techniques and other scientific breakthroughs.

But this is only the beginning.

Accelerating the path to the next 1 million

Living It Forward, a national initiative led by UNOS in partnership with the nation’s organ donation and transplant community, calls to further accelerate the pace of lifesaving transplantation while commemorating so many lives saved, recognizing those still waiting, and remembering those we have lost.

Visit to read and share stories about some of the people behind the 1 million and see how the gift of life has allowed them to begin living it forward.

Register now to live it forward: Become an organ donor

UNOS encourages everyone to become part of our community by registering as an organ donor. One person can save up to eight lives through organ donation and change the lives of as many as 75 through tissue donation. Because only two percent of people die in a way that makes organ donation possible, the need is great. More than 100,000 people remain on the transplant waitlist. Please register today at


UNOS proudly recognizes sponsors whose generosity helps make our lifesaving mission possible.
Learn about sponsorships and our editorial standards.