Organ donation saves lives. The use of organ transplantation to treat people with end-stage organ failure is both medically effective and cost-effective and is now considered mainstream medicine. Although some persons cannot access this treatment for the same sociological, economic, and educational reasons that they cannot access other medical treatment, most cannot gain access because the necessary ingredient—the organ—is missing. The United Network for Organ Sharing (UNOS) national waiting list of patients in need of an organ has nearly 90000 names. Organ-specific waiting lists have grown so large that the mean waiting time for a kidney now exceeds 3 years. Waiting time for extrarenal organs (eg, hearts, lungs, livers) is limited by the one leveling factor that will eventually end the waiting: death. In 2004, a total of 7151 patients died while waiting for an organ transplant.1 

To address this crisis, in April 2003, Health and Human Services Secretary...

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