Updated Mar 22, 2023, 3:11pm EDT
North America

The US wants to reform its organ transplant system. Here's what other countries have tried

Doctors performing surgery
National Cancer Institute/Unsplash

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The News

U.S. officials on Wednesday announced a proposal to reform the country's troubled organ transplant system that has been criticized for being opaque and leaving too many patients on waiting lists for organs.

Seventeen Americans die every day waiting for an organ transplant, but the shortage of organ donors isn't a problem just confined to the U.S., as other countries have struggled over the years to make organ supply meet demand. Here are some of the reforms other nations have tried.

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Know More

The U.S. Health Resources and Services Administration on Wednesday announced that its new "modernization initiative" includes the release of new data dashboards detailing organ availability and the match process. The White House's proposed new budget would also double the amount of money put toward organ-related work.

The administration also wants to allow other organizations to bid to take on organ transplant services. The nonprofit United Network for Organ Sharing is the only entity to ever operate the country's transplant system, The Washington Post explained.

The government is seeking to "enhance performance and innovation through increased competition," according to a press release.

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The View From Iran

Iran is known for laws that make it legal for people to buy and sell kidneys. A government organization matches up buyers and sellers, with a fixed price, which The Los Angeles Times reported in 2017 was $4,600 per organ.

Proponents say the system gives people a way to make money and save lives, and reduces transplant wait times. But some sellers have gone around the system to cut deals with wealthy Iranians who need a transplant and don't want to wait, the Times reported.

And some doctors have been caught trying to perform transplants on Saudis who forged Iranian IDs.

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The View From Israel

Israel has been known for its high rates of "transplant tourism," in which citizens leave the country to get organ transplants. The country suffered from low rates of donation consent, in part because some Orthodox Israelis are opposed to organ harvesting on religious grounds, Tablet Magazine reported.

In 2012, the country changed its policies to reward the willingness to donate. It gives transplant priority to people who are themselves organ donors, and their families.

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The View From The U.K.

The countries within the United Kingdom have each taken steps toward an "opt-out" system, in which all adults are considered organ donors when they die unless they specifically choose not to donate.

Wales, England, and Scotland have all switched to an out-out system in the last few years in an effort to increase the number of available organs, and Northern Ireland is set to officially do so this year.

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Room for Disagreement

In an academic paper published in 2021, Harriet Etheredge, a medical bioethicist, argued that switching to an "opt-out" system for organ donations isn't necessarily a silver bullet that will increase donations.

Data from countries that have tried the opt-out system "are often contradictory and largely inconclusive, suggesting other factors may be in play," Etheredge wrote.

For many countries, she argued, it may be more advantageous to focus on providing additional resources to the donation system already in place, rather than entertain a wholesale shift in procedures.


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