In 1984, the National Organ Transplant Act (NOTA) began to provide a comprehensive structure and articulated policy regarding organ transplantation. This legislation reflected Congress’s acknowledgement of the advances being made in transplantation technology and procedures. For example, there was now an 80 percent survival rate for those undergoing kidney transplants. And the drug cyclo-sporin had increased the survival rate of liver transplant patients from 35 to 70 percent for the first year after undergoing a liver transplant. Of course, there was still great concern about the shortage of available organs.
NOTA also provided funds for grants for qualified organ procurement organizations (OPOs) and an Organ Procurement and Transplantation Network (OPTN). The OPTN was intended to assist OPOs in distributing organs that could not be used in the OPO’s geographical area. The Act provided grant money for planning, establishing, and operating or expanding organ procurement organizations. To qualify for the grant money, the OPO had to show that it was a nonprofit organization qualified to receive Medicare reimbursement for kidney procurement. It also had to describe established procedures to obtain payment for organs (other than kidneys) that were provided to transplant centers. The Act expressly forbade selling human organs across state lines. Apparently, the committee responsible for this provision felt strongly that human body parts should not be viewed as commodities.
One of the most important achievements of the Act was the establishment of a 25-member Task Force on Organ Transplantation. This task force studies human transplant policy issues, including organ procurement and distribution. The Task Force published its first report covering medical, legal, social, ethical, and economic issues related to organ procurement and transplantation in 1986. In this report, the Task Force commented on the relatively small percentage of transplantable organs that were actually harvested for transplantation and the need to increase this supply. It urged the continued development of organ transplant policies that encourage individuals to donate organs.
