Organ transplantation is established therapy for many patients with a variety of end-stage diseases. The survival benefits are remarkable, as are the improvements in quality of life. Unfortunately, the supply of donor organs remains insufficient to meet the need.

Recently, through participation in the breakthrough collaboratives of the Health and Human Resources Administration, organ procurement organizations (OPOs) have become engaged in systems change through application of the principles of continuous improvement. So-called best practices are being shared by OPOs. This sharing, in turn, has created a level of synergy among OPO professionals and hospitals alike that is having a positive impact on the donor supply (Table 1).

Clearly, reasons for optimism exist, but a stark reality must be confronted: there will never be a single solution to the donor dilemma. Organ donation is multifactorial, a fact that often eludes people who are consumed by the search for a “magic...

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