U.S. Transplant System Faces Efficiency Scrutiny
The national organ network continues to navigate systemic challenges as thousands remain on waiting lists.
Updated on Oct. 20, 2026 in Healthcare
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Following a June 2025 intestine transplant, the national system for organ procurement remains under intense scrutiny. With 100,000 Americans on waiting lists, the process for matching donors with recipients continues to face significant logistical hurdles.
Why it matters
The organ transplant network is undergoing a federal overhaul due to wide disparities in transplant speeds and high rates of unused donations. Hospitals frequently decline organ offers based on surgeon preferences regarding donor age, organ anatomy, and center performance metrics.
Approximately 1 in 5 donated organs currently go unused, while research indicates a 16-fold variation in kidney transplant speeds between different medical centers. Last year, the nation recorded 27,000 kidney transplants out of 49,000 total procedures.
The players
Katherine Screws
She is a Phoenix resident who underwent an intestine transplant in 2025 following a serious 2022 car accident.
Georgetown University Hospital
This medical center served as the site for the intestine transplant procedure.
The details
Recipient Katherine Screws, a Phoenix resident, received an intestine transplant in June 2025 after facing nine rejections for potential organ offers throughout 2024. Surgeons and procurement organizations rely on an automated system to generate priority lists, but final acceptance often depends on specific center policies.
Timeline
May 2022: Katherine Screws suffered a car crash causing small intestine loss.
2024: Nine organ offers were rejected for Katherine Screws.
June 2025: Katherine Screws received an intestine transplant at Georgetown University Hospital.
Market Landscape
The current organ procurement landscape is defined by the efforts of 55 distinct organ procurement organizations and the federal Medicare organ procurement pilot project. These initiatives seek to address systemic inefficiencies and reduce the high rate of declined organ offers across the nation.
For patients awaiting life-saving procedures, the current system results in inconsistent wait times and frequent organ rejections. Understanding these complexities is essential for families navigating the transplant list and engaging with hospital procurement policies.
The takeaway
Organ matching is a complex process influenced by a variety of clinical and institutional factors. Patients should consult with their medical teams to understand how specific hospital policies might influence their individual waiting time.
Further reading
Learn more about the federal initiatives impacting the industry on the United States Healthcare page.
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