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February 5, 1988

The National Organ Procurement and Transplantation Network

JAMA. 1988;259(5):725-726. doi:10.1001/jama.1988.03720050061025

THE NATIONAL Transplantation Act of 1984 (Public Law 98-507, Section 372) established a national health policy regarding transplantation. Public interest in this scientific field has caused concern in the professional community.1 This commentary is submitted to clarify the situation.

About five years ago a new immunosuppressive agent came into general use. This agent, cyclosporin, substantially improved renal allograft success, but more important, it revolutionized the transplantation of hearts and livers. There ensued a remarkable increase in the number of transplantations performed in this country. In the past six years the number of renal transplants performed yearly has increased from 5000 to approximately 10 000. Heart transplants have increased from a handful to about 1400 in 1986. Similarly, liver transplants have increased from a negligible number to about 900 in 1986.

This sudden increase in demand for transplantable organs created a crisis. The profession had produced a remarkable scientific achievement