In the U.S., thousands of donated organs never reach the patients who need them.
CBS News found that last year, one in three kidneys recovered from deceased donors were never transplanted.
Specialized organ recovery teams made more than 26 million attempts to place these kidneys with transplant centers, offering them again and again in search of a suitable match–before they were ultimately discarded as medical waste.
And it’s not just kidneys. Nearly 12,000 potentially life-saving organs were discarded last year in the United States.
Mitch Potter, a 31-year-old Michigan resident, tragically passed away in a car accident, leaving behind his girlfriend, three children, and a mother grieving his loss.
Despite this heartbreak, Mitch saved multiple lives by donating his organs, giving others the chance to live on.
“I’m very proud and very happy,” said his mom, Cheryl Potter. “There are people out there who need what he has, and he was willing to give it. He’s living on in other people,” she said.
Mitch’s heart went to Minnesota
His kidneys went to patients in Michigan and Illinois.
His liver traveled hundreds of miles to Washington, D.C., but it was ultimately not used.
The Washington hospital told a spokesperson representing the recovery team that placed Mitch’s organs that the liver did not meet their standards.
“I didn’t know he was a donor,” said Cheryl Potter. “I’m super proud of him.”
Why are organs discarded?
A CBS News analysis of federal procurement and transplant data found kidneys are discarded the most. Nearly one-third of kidneys recovered never make it to a patient.
“The number should be more like 1 in 20,” said Dr. Richard Formica, president of the Organ Procurement and Transplantation Network that oversees the U.S. transplant system. “I consider this to be an existential threat to the whole transplant system.”
To understand why so many organs are discarded, it’s important to understand how the system works.
Organs go unused for many reasons, including logistical challenges, organ quality, rising donation rates and performance measures.
The process involves two players: organ procurement organizations (OPOs) and transplant centers. The procurement organizations identify donors, recover organs, offer them to patients on the waiting list, and arrange transportation. Transplant centers evaluate patients, accept suitable organs, and perform transplant surgeries.
Both are rated by the federal government to try to improve patient outcomes.
Procurement organizations are incentivized to recover as many viable organs as possible and try to match them with recipients.
Transplant centers may be more selective, choosing patients and organs that create the best chance of long-term success.
Those competing performance measures contribute to a system where more organs are recovered than ever before–and more organs are being thrown away.
According to the Centers for Medicare and Medicaid Services, low-ranking organ procurement organizations risk losing federal funding if they do not meet performance measures. Transplant centers with lower ratings may struggle to attract patients or insurance contracts, Formica said.
“That creates a certain level of risk aversion and encourages transplant centers to say no more often than yes,” says Dr. Sumit Mohan, a Columbia University kidney specialist. “As a result, transplant centers don’t do as many transplants as they could.”
The National Academies of Science, Engineering, and Medicine also expressed concern, stating in a 2022 report, “There is evidence to suggest that some transplant providers might be rejecting good organ offers that could benefit the recipient because of a reluctance to perform riskier surgeries for fear it could damage the transplant center’s statistics.”
The organization that tracks performance measures says that it accounts for those risks. It also holds seminars to explain that taking risks, such as transplanting a less-than-perfect organ, will not necessarily hurt a transplant center’s ratings.
Video: Watch how organs are matched to recipients
Breaking barriers to transplants
Federal health officials are exploring ways to reduce organ discards and improve the placement process.
In a recent OPTN meeting, they highlighted Hackensack University Medical Center, where Goldstein, a transplant surgeon, and his team transplant riskier kidneys that other centers may turn down. Patients start their transplant journey with a PowerPoint explaining the benefits of choosing a less-than-perfect kidney.
Goldstein engages patients in the decision-making process, encouraging them to weigh the risks of waiting for a “perfect” kidney against the dangers of staying on dialysis.
“When you’re sitting on a waiting list, that’s the worst place to be because the risk of dying increases for every day someone remains in kidney failure. So, the choice of which organs you’re willing to accept is about choosing life,” he said.
Dialysis keeps patients alive by filtering waste from their blood, but it’s not a long-term solution to those with kidney failure. The longer someone stays on dialysis, the higher they are at risk of complications including cardiovascular disease, infections and declining quality of life.
Clifford Toliver, 73, faced that choice. Diagnosed with renal disease, he started dialysis in 2022.
“They put the needles in your arm, and you sit in a chair for four hours. You watch TV. You go to sleep. That’s all you can do,” he said. “This is going to be the rest of your life. And this is how you’re going to die.”
Under Goldstein’s care, Toliver took a chance on a kidney others might have refused.
“The kidney was 65 years old. That’s younger than me. And I know today people live to 99, 100,” he said. “If I refuse the kidney, I might not match again ever.”
Hackensack’s transplant program accepts kidney offers at three times the national rate and still has a 97.5% patient survival rate one year after surgery, according to the Scientific Registry for Transplant Recipients.
“We’re trying to figure out how to remove disincentives, as well as to incentivize transplant hospitals to do more,” Goldstein said.
Reducing organ discards requires a shared commitment.
“The more transplant hospitals and OPOs partner together to be part of the solution, to find homes for kidneys that are hard to place, the better we are as a community,” Goldstein said.
For patients like Melanie Knoll, that shift could mean the difference between life and death.
She is a diabetic whose kidney failed. No one in her family is a suitable match. She’s spent the last three years on dialysis waiting for a donor.
“If a kidney has the potential to be viable, I would much rather explore that than to continue to just live a life on dialysis,” said Knoll, who lives in Michigan.
She would accept a less-than-perfect kidney, especially considering the alternative.
“I hope I don’t die waiting for a kidney.”
Justin Sherman / CBS News
Credits
Reporting: Tom Hanson, Aparna Zalani | Data Analysis: Rachel Gold | Photographer/Editor: Justin Sherman | Visual Design and Web Development: Grace Manthey, Taylor Johnson, Aaron Munoz | Editing and project leadership: Nicole Vap, Chad Cross, John Kelly, Aparna Zalani
