Organ Procurement in the United States- A Historical Review of Legislative and Regulatory Breakthroughs in the Development of a New Healthcare Subsector

Abstract

The remarkable progress of transplant medicine in the latter half of the twentieth century has led to an unprecedented demand for donated organs that have historically remained in short supply. Although a clinically effective procedure, organ transplant’s health benefit to the society is seriously limited by the shortage of organs. While the number of donors has been increasing at a steady rate, the number of people who can be effectively treated with a transplant has, far out-paced the supply of organs. It is therefore ironical that the benefits of transplant medicine are limited by the consequence of its own success. And it is this great paradox that makes this issue interesting and challenging. This review is second of the two-part series. Previously, we have described the historical developments that led to the rise of organ transplantation as the treatment of choice for end-stage organ disease. In this review, we recount how the society has responded to the increasingly evident need for transplantable organs and the ethical issues concerning removal of organs from the human body.  Central to this discussion is the role of regulatory and legislative breakthroughs in the evolution of the United States organ procurement and transplantation network into its current form.