The National Organ Transplant Act

In 1983 a Virginia physician proposed a commercial brokerage in which patients could buy kidneys from living donors. The idea was unpopular, and in the autumn of 1983 Representatives Albert Gore Jr. of Tennessee and Henry Waxman of California held hearings on transplantation. Gore had introduced a National Organ Transplant Act bill on 5 October. The proposed legislation had three aims: more organs through support for procurement agencies, help paying for costly immunosuppressive drugs such as cyclosporine, and a ban on buying and selling organs.

The National Organ Transplant Act became law on 19 October 1984. Title III made it unlawful to knowingly acquire, receive or transfer a human organ for valuable consideration for use in transplantation, with fines up to $50,000, prison up to five years, or both. The law listed kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone and skin, and excluded reasonable costs of removal, transport and storage and a donor's travel, housing and lost wages.

The act also set up a 25-member Task Force on Organ Transplantation to study the medical, legal, ethical, economic and social questions, including the cost of immunosuppressive drugs. It authorized grants to organ procurement organizations and a contract for an Organ Procurement and Transplantation Network, a private nonprofit body required to keep a national list of people needing organs, run a computer system to match organs to them by medical criteria, staff a 24-hour telephone service and publish data. A separate scientific registry was to track transplant recipients. Funding for immunosuppressive drugs was dropped from the final bill.

The contract for the network went to the United Network for Organ Sharing in 1986. A national point system for allocating kidneys began on 1 November 1987. A second law in 1986 set federal standards for procurement organizations, required hospitals to follow procedures for approaching potential donors' families and brought immunosuppressive drugs under Medicare coverage. The Transplant Amendments of 1990 added a national bone marrow registry.