JAMA: The Evolution of Deceased Organ Donation in the US

[Clark]

https://jamanetwork.com/journals/jama/article-abstract/2845580

The Evolution of Deceased Organ Donation in the US
Aleah L. Brubaker, MD, PhD1; Jesse D. Schold, PhD, MStat, MEd2,3;  Gabriel T. Schnickel, MD, MPH1
JAMA
Published Online: February 26, 2026
doi: 10.1001/jama.2026.0621

Modern transplantation began in 1954 when Joseph Murray, MD, successfully transplanted a kidney from one identical twin brother to another. Since then, the US transplant system has evolved through a public-private partnership to address trust, ensure equity, and expand access. In 1968, the Uniform Anatomical Gift Act created a state-level legal basis for organ donation, establishing an individual's right to make an anatomic gift after death. Rapid adoption of this act led to emergence of regional organ procurement organizations (OPOs), formed as extensions of transplant centers or hospital networks, and ad hoc operating practices shaped by local hospital relationships and various legal interpretations.
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