Prior to 1968 there were no federal laws dealing with organ and tissue donation. Before the Uniform Anatomical Gift Act of 1968 (AGA), organ and tissue donations were handled at the state level only. Unfortunately, the state laws then on the books differed considerably from state to state. The AGA was intended to address these problems by providing a framework of uniform laws in the United States relating to organ and tissue transplantation. It also attempted to increase the number of available organs by making it easier for individuals to make anatomical gifts.

In 1972, The Uniform Anatomical Gift Act mandated that the Uniform Organ Donor Card be recognized as a legal document in all 50 states. This empowered anyone eighteen years or older to legally donate his or her organs upon death.

In 1984, the National Organ Transplant Act (NOTA) created a national computer registry of donated organs. It was to be operated by the United Network for Organ Sharing (UNOS). NOTA also authorized financial support for organ procurement organizations and outlawed the purchase or sale of human organs.