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UNOS Struggles to Fairly Distribute Livers

What Is The United Network for Organ Sharing?

The United Network for Organ Sharing (UNOS) is a contracted organization that works with the federal government to create an organ donor list. This list is ordered based on the needs of the patients and decides who is the most in need of an organ and who is best able to care for the organ. The UNOS organization also considers the likelihood of the patient’s survival if they receive an organ, a patient’s support system, and the best possible outcomes. The intention is to provide organs to those with the best chance of survival so that no donated organ goes to waste in a patient who is too sick to survive or whose lifestyle is not conducive to properly taking a lifetime of anti-rejection medication in order to keep the body from rejecting the organ. This organization always has to choose which patients have the opportunity to survive and which are not qualified to receive an organ. Certainly, this can result in debates as the organization has to weigh medical records and predict the future of a patient based on their past. Some argue that this is an inexact science which can prevent some from receiving the organs they so desperately need.

Why Aren’t There Enough Organs?

There are two main reasons that there are not enough organs; first that not all organs are viable options for donation and second that some illnesses are rampant enough to require more organs than are available.

When considering organs for donation, there are two situations involved; first, does the person who was born with the organs want to donate them?  This question is focused on either a living donor situation where a person could donate an organ but would undergo surgery and a potentially long and painful recovery if they choose to undergo the procedure. This may look selfish to some, but there are risks with any type of surgery and not everyone wants to or is able to take on the risks of a surgical procedure that is not necessary for their own wellbeing. For those who have died, sometimes a hospital does not know whether the person wanted their organs to be donated. This can lead to a difficult conversation with family members, who may also not know what the person wanted or who may not like the idea of losing a physical part of their loved one in the first moments of realizing that person has died.

Second, not all organs are viable. In the best case scenario, a person is healthy and they are involved in some sort of an accident that leads to their death but does not harm the organs, thus allowing the organs to be used in donor recipients. However, often people who die do so of old age or of an illness, which can impact the organs and make them not useable. This may mean that the organ is not functioning properly or, for example, the cancer that killed a person also impacted the organ. In these cases, even if the person was a registered organ donor, the organs cannot help anyone so they will not be donated.

How Does This Impact People With Hepatitis C?

People with hepatitis C are more likely to need a liver transplant than the average person. Since the virus often exists in the body for months or years before the patient is aware and is able to begin treatment, the virus can cause damage to the liver. If enough time passes, this damage can become permanent and, in some cases, it can result in the need for a transplant.

What Can I Do To Help?

If you are interested in becoming an organ donor, you should sign up for the aspects of donation that feel right for you. Some people only wish to donate in the event of their death. In this case, most states allow noting this on the person’s driver’s license or state identification. If yours does not, you can go to your local department of motor vehicles and ask that this be added. In addition, some choose to add this information into their legal documentation such as a living will or a will. In these documents, the person can choose which organs they wish to donate, whether they want to donate everything possible, or whether there are only specific items they are allowing to be used for donation.

If you are interested in becoming a blood and organ donor while you are alive, you can complete a basic internet search and learn about the processes and protocols through organizations that match donors to those in need. Often, the process is quite simple and requires very little from the potential donor to sign up for their donor registry. Many send a small package and require only a cheek swab or some saliva in order to have their genetic information placed in the computer system. Then, all a potential donor has to do is keep their records updated with the company each time they move. If a person in need is found to be a match, the organization will contact the potential donor with more specific information about what type of donation is needed and what the process will require. Typically, the costs associated with donation are covered by the organization or the recipient’s insurance. If this sounds like something that might be of interest, you can review your options via organizational websites and/or discuss your thoughts with your doctor.1-4

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Naugler, W. (2016). California has long wait lists for liver transplants, but not for the reasons you think. Retrieved 30 March 2017, from
  2. Rice, S. (2014). Organ transplant group struggles to address disparities in access to donated livers. Modern Healthcare. Retrieved 30 March 2017, from
  3. Stolberg, S. (1999). Organ Transplant Panel Urges a Broad Sharing of Livers. Retrieved 30 March 2017, from
  4. Transplants: Why Demand Exceeds Supply. (1990). CQ Researcher by CQ Press. Retrieved 30 March 2017, from