More adults are surviving both the wait for an organ and transplant surgery, but the number of people who need transplants continues to exceed the number of organs available, especially for kidneys, according to a national analysis published in the Journal of the American College of Surgeons (JACS).
Researchers from Baylor College of Medicine in Houston, Texas, analyzed nearly 1.5 million listings of adults in the United Network for Organ Sharing (UNOS) database from January 1987 to July 2024. Their analysis focused on three key metrics and is considered one of the most comprehensive analyses of long-term trends in adult solid-organ transplantation to date.
About 13 people die every day waiting for a transplant, and more than 100,000 adults and children are waiting for an organ. With growing demand, a record 49,064 transplants were performed in 2025.
"Organ transplant patients are living longer both before and after surgery thanks to several clinical and technical innovations," said senior author Abbas Rana, MD, FACS, professor of surgery at Baylor College of Medicine. "But there remains a significant need for organ donations, and that unmet need hampers any progress we have made in survival."
The improved survival rates likely reflect advances in anesthesia, critical care medicine, and infectious disease medicine that have improved outcomes after organ transplantation and allowed people on waitlists to live longer. The authors noted that better organ preservation strategies and expanded donation criteria have also played important roles in increasing access; however, these effects do not always extend equally across all types of organs.
Other emerging technologies such as xenotransplantation have shown promise in limited clinical trials but are not yet widely available or sufficiently developed to address the gap between supply and demand meaningfully. "Our field has made tremendous advancements, but those advancements can only be truly realized with increased donations," Dr. Rana said. "This research was another way for us to highlight just how influential and significant the organ supply is to maintain progress." The study's limitations include potential gaps within the UNOS database regarding regional differences or socioeconomic factors, as well as changes over time in eligibility criteria or risk factors.
