National transplant waiting list

The organ donation gap refers to the persistent shortfall between the number of people in the United States who need an organ transplant and the number of organs available for transplantation.[1][2] The gap is most visible in the national transplant waiting list, maintained as part of the Organ Procurement and Transplantation Network (OPTN), which has held roughly 103,000-105,000 candidates in recent years, the large majority awaiting a kidney.[1][2]

All figures in this article are point-in-time. The waiting list is a live counter that changes continually as candidates are added, transplanted, removed, or die; donor and transplant totals are annual figures that HRSA, the OPTN, and UNOS revise. Readers should treat the numbers below as snapshots and re-confirm them against the cited primary pages, each of which carries its own retrieval date.

The waiting list

As of mid-2026, the national waiting list stood at roughly 103,000 candidates, of whom about 85-87% were waiting for a kidney (on the order of 90,000+ candidates).[1][2] The number of candidates differs from the number of registrations: a single person can be listed at more than one transplant program ("multiple listing"), so registration counts run higher than the count of distinct candidates.[1] Editors should specify which is meant.

The waiting list passed 100,000 candidates in 2021 and has remained near or above that level since.[1][3] An older figure of "114,000," sometimes still quoted, reflects an earlier peak in registrations and should not be used as a current candidate count.[1]

Donation and transplant volumes

Against the waiting list, the supply side has grown over the past decade, even as it falls short of need:

• 2024 set a national record of 48,149 transplants, comprising 16,988 deceased donors (enabling 41,119 deceased-donor transplants) and 7,030 living donors.[4][5]
• 2025 preliminary figures showed more than 49,000 transplants (about 49,064), but deceased donation declined about 2.5% to 16,550 deceased donors, the first decline in deceased donation in more than a decade, even as the total transplant count again reached a record on the strength of living donation and per-donor organ yield.[6]

Kidney transplants make up the largest share of activity, consistent with the waiting list's kidney-heavy composition.[4][5]

How the gap is described to the public

U.S. public-health messaging frames the gap in human terms. HRSA's organdonor.gov currently states that, on average, about 13 people die each day in the United States while waiting for a transplant (retrieved 2026-06; this current figure replaces a legacy "17 per day" figure that still circulates).[2] Donate Life America and HRSA also use the messaging that one donor can save up to 8 lives through organ donation and enhance the lives of up to 75 more (commonly cited as "more than 75") through tissue and cornea donation; this is advocacy/awareness messaging and should be attributed to Donate Life/HRSA rather than presented as a clinical statistic.[2][7]

A new candidate is added to the national waiting list every few minutes, according to HRSA public materials; because the exact interval is a live, periodically updated figure, it should be cited to the current organdonor.gov page with a retrieval date rather than fixed in text.[2]

Drivers of the gap and policy responses

The gap reflects both demand (rising rates of organ failure, especially end-stage kidney disease) and supply constraints (a limited pool of medically suitable deceased donors, variation in donation and recovery performance, and organ non-use/discard).[1][2] Policy efforts to narrow it include:

• OPO performance reform under CMS-3380-F (2020), which introduced objective donation- and transplantation-rate measures and tiering for OPOs, with the first recertification cycle using 2024 data and decisions in 2026.[8]
• OPTN modernization since 2023 under the Securing the U.S. OPTN Act, aimed at improving the system that manages the list and allocates organs.[9]
• Continued growth in living donation and in technologies (such as machine perfusion) that increase the number of transplantable organs per donor.[6]

These responses are covered in the linked articles and presented here without endorsement.

See also

• Organ Procurement and Transplantation Network (OPTN)
• Organ procurement organization (OPO)
• HRSA Division of Transplantation
• Scientific Registry of Transplant Recipients (SRTR)
• Organ donation · Living donation · Deceased donation
• Kidney transplantation

References

• Congressional Research Service. Organ Procurement and Transplantation: Administration, Oversight, and Policy Issues, R48426. https://www.congress.gov/crs-product/R48426
• organdonor.gov (HRSA). Organ Donation Statistics. https://www.organdonor.gov/learn/organ-donation-statistics
• OPTN. National data, waiting list. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/
• HRSA. Organ Transplants Exceeded 48,000 in 2024; a 3.3 Percent Increase From the Transplants Performed in 2023. https://www.hrsa.gov/optn/news-events/news/organ-transplants-exceeded-48000-2024-33-percent-increase-transplants-performed-2023
• UNOS. U.S. surpassed 48,000 organ transplants in 2024. https://unos.org/media-resources/releases/u-s-surpassed-48000-organ-transplants-in-2024/
• UNOS. U.S. surpasses 49,000 organ transplants while deceased organ donations dip. https://unos.org/media-resources/releases/u-s-surpasses-49000-organ-transplants-while-deceased-organ-donations-dip/
• Donate Life America. Organ, eye and tissue donation statistics. https://donatelife.net/donation/statistics/
• Federal Register. OPO Conditions for Coverage: Revisions to the Outcome Measure Requirements (CMS-3380-F), 85 FR 77898 (Dec. 2, 2020). https://www.federalregister.gov/documents/2020/12/02/2020-26329/medicare-and-medicaid-programs-organ-procurement-organizations-conditions-for-coverage-revisions-to
• Securing the U.S. Organ Procurement and Transplantation Network Act, Pub. L. 118-14 (2023). https://www.congress.gov/bill/118th-congress/house-bill/2544