Every year, tens of thousands of Americans wait in what they call "medical purgatory" for an organ transplant. In 2018 there were more than 36,529 organ transplants, a number that has risen by 20 percent over the last five years. However, there are far more sick patients waiting on the transplant list — about 114,000 total, according to data from United Network for Organ Sharing (UNOS), which serves as the national Organ Procurement and Transplantation Network under federal contract. That's why an average of 8,000 people die every year waiting for the organs they need.
Now researchers, doctors and policymakers are exploring new strategies to increase the supply of organs needed to meet demand. Among the promising pursuits: advancing stem cell research in an effort to heal damaged organ tissue; developing biofabrication techniques in an effort to fast-track the 3D manufacturing of human organs, and using gene-editing techniques to find safe ways to use pig organs for human transplants.
The coordinated movement comes at a time of crisis in America. Rising obesity and diabetes rates is taking a toll on the human body. It is increasing the incidence of kidney disease and a form of fatty liver disease known as nonalcoholic steatohepatitis (NASH). These conditions typically lead to kidney and liver failure in people as young as 30. Even the pediatric population has been affected. For these individuals an organ transplant is their last hope.
"Recognizing the trend, UNOS is looking for ways to widen the donor pool and improve the way organs are allocated for transplantation nationwide," said Dr. David Klassen, UNOS' chief medical officer.
Right now it is rewriting distribution algorithms to improve the access of organs geographically. It is also exploring ways that would let transplant centers accept organ donations more quickly.
One strategy being used to address the immediate need is the use of living donors. Last year 19 percent of all transplant surgeries in the United States were from living donors, the highest in 12 years, reports UNOS. In these surgeries donors give a portion of an organ (i.e. liver) or an entire organ such as a kidney to another person whose organ is no longer functioning properly.
Another is broadening the set of medical criteria for organ donations. For example, now hospitals are using livers that are infected with the hepatitis C virus in transplants and then curing patients of the disease with new drugs — i.e. Harvoni, AbbVie and Sovaldi — after surgery. There is even a UNOS-approved program at Johns Hopkins Comprehensive Transplant Center that transplants organs, such as livers and kidneys, from living donors infected with HIV to patients who already have the virus.