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Abstract
Evolving Trends in Organ Donation, Recovery, and Utilization in the United States: A Decade of Change and the Impact of COVID-19 Background: Over the past decade, organ donation and transplantation in the U.S. have undergone substantial changes, influenced by evolving donor practices and the COVID-19 pandemic. We examined national trends in donor types, organ recovery, utilization, and discard rates between 2012 and 2023. Methods: We analyzed SRTR/OPTN registry from 2012–2023, including total deaths, DBD (donation after brain death); DCD( donation after circulatory death); NRP (normothermic regional perfusion), organ authorization, recovery, transplantation, and discard rates. Pre-COVID (2016–2019) was compared with post-COVID (2020–2023). Results: A total of 259,544 deaths and 134,625 DD were analyzed. DD increased by 100.6% and DD per death by 52.7%. DBD remained predominant (76.5%), but DCD donors increased markedly—especially DCD with NRP (+1496.3%). Organ authorizations, recoveries, and transplants rose 106.3%, 97.4%, and 76.1%, respectively. Post-COVID, donations, recoveries, and transplants increased significantly, but organ recovery and transplant efficiency ratios declined.Kidneys and livers remained the most commonly recovered and transplanted organs. Average organs transplanted per donor declined post-COVID (2.75 vs. 3.05, p=0.009), with decreases across most organs, particularly pancreas, liver, heart, and lung. DCD with NRP donors showed increased yield, while DBD and DCD without NRP declined. Discard rates rose for most organs, with pancreas and kidney having the highest. Conclusion: Despite substantial increases in donor numbers and organ availability, organ utilization efficiency has declined post-COVID. The rapid growth of DCD, particularly with NRP, represents a critical opportunity for expanding the donor pool. Efforts to reduce discard rates and improve utilization efficiency will be essential to maximize transplant benefit in the coming decade.
Publication Date
2026
Subject Major(s)
Public Health
Keywords
Organ Donation, Organ Utilization Efficiency, Organ Discard
Disciplines
COVID-19 | Health Services Research
Current Academic Year
Senior
Rights
© The Author(s)
Recommended Citation
Rokad, N. & Tripathi, O. (2026). Evolving Trends in Organ Donation, Recovery, and Utilization in the United States: A Decade of Change and the Impact of COVID-19. Virginia Commonwealth University, University of Connecticut.