also, the $3000 is not the center fee, it is the cost of the transplant, just like the SAC fee is not paid by the center but the patients insurance, why should they pay for this when the insurance company wont) its not the joining fee, the connectivity fee, the late data fee etc that the center pays to participate. Some centers choose to pay it, others do not, maybe they do better doing internal swaps, maybe they do just fine with UNOS or the Alliance, there are many large programs that do not participate with NKR for many reasons and not being invested with their patients is certainly not one of them. There are 155 programs that participate with UNOS and hopefully that will continue to grow.