OPTN/SRTR 2024 Annual Data Report: Overview of US Solid Organ Transplantation

Allyson Hart^1,2, David P. Schladt¹, Jon J. Snyder^1,2,3

¹Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN

²Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN

³Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

Abstract

The OPTN/SRTR 2024 Annual Data Report provides information about and trends in solid organ transplantation in the United States from 2013 through 2024. Overall, 2024 data reveal ongoing steady increases in volume; the numbers of patients on waiting lists, transplants performed, and organs recovered in solid organ transplantation all continued to reach record levels, reflecting a mix of ongoing improvements as well as persistent challenges in meeting the needs presented by patients with organ failure. This overview provides information about US solid organ transplantation as a whole, while organ-specific chapters provide more detail on kidney, pancreas, liver, intestine, heart, and lung transplant. These organ-specific chapters generally provide data on both adult and pediatric transplant, as well as descriptive data on waiting lists, transplants (including deceased and living donor transplant when applicable), and patient outcomes. Deceased donor recovery information is presented in a separate chapter, although some organ-specific data on donation are presented in their respective chapters. A brief chapter covers vascularized composite allograft transplant.

Keywords: Organ transplant, patient survival, waiting list

1 Trends in Solid Organ Transplant Waiting Lists

In 2024, a total of 167,230 unique patients (ie, counting candidates once when listed at more than one center) were on a waiting list for a solid organ transplant in the United States, with 70,600 added to the list during the year. Trends in the number of patients on waiting lists vary by organ. The total number of annual period-prevalent patients on the kidney, liver, lung, simultaneous kidney-pancreas, and intestine waiting lists have remained fairly stable since 2013. The total kidney transplant waiting list (including listings for the same candidate at more than one center) increased slightly to 147,091 in 2024 from 139,715 in 2013, and liver candidates decreased to 25,538 in 2024 from 28,484 in 2013 (Figure OV 1). The number of patients waiting for a lung transplant increased to 4,775 in 2024 from 4,257 in 2013, while those awaiting simultaneous kidney-pancreas transplant increased slightly (3,721 from 3,428). Conversely, the number waiting for a pancreas-alone or pancreas-after-kidney transplant decreased: 996 in 2024 compared with 1,536 in 2013. The number of patients waiting for intestine transplant decreased slightly to 339 in 2024 from 349 in 2023. The most substantial waitlist size increase was among heart transplant candidates: 9,444 in 2024 versus 7,456 in 2013 (Figure OV 2).

The relative stability of the total number of patients on waiting lists does not reflect movement on and off of the lists. The number of patients added and removed (including those removed due to receiving transplant) has also increased. For example, despite the overall stability in the total number of patients on the kidney transplant waiting list, the number of candidates added to the kidney waiting list has increased steadily, particularly since 2020 after a small downtrend corresponding to the beginning of the COVID-19 pandemic. In 2024, there were 50,481 patients added to the kidney transplant waiting list, compared with 38,622 in 2013 (Figure OV 3). Additions to the liver transplant waiting list increased slightly but steadily, to 15,395 patients added in 2024 versus 12,008 candidates added in 2013. The heart and lung transplant waiting lists also had increases in new listings. There was a 50.6% increase in newly listed heart candidates: 6,068 in 2024 compared with 4,030 in 2013 (Figure OV 4). Similarly, 3,822 lung candidates were added in 2024 compared with 2,575 in 2013. Kidney-pancreas additions increased slightly less (1,667 in 2024 versus 1,271 in 2013), while additions for pancreas-alone or pancreas-after-kidney actually decreased (312 in 2024 versus 477 in 2013), as did additions to the intestine waiting list (128 in 2024 versus 180 in 2013).

2 Trends in Total Transplants

As the total number of patients added to waiting lists increased in 2024, so did the total number of transplants; 46,750 solid organ transplants were performed in 2024, up from 29,768 in 2013. The total number of transplants performed annually has steadily increased over the past decade in all but pancreas and intestine transplants. The total numbers of kidney, liver, heart, and lung transplants have increased by a range of 61.4% to 81.5% since 2013, with kidney transplants increasing to 28,492 in 2024 from 17,658; liver transplants to 11,458 from 6,455; heart transplants to 4,636 from 2,554; and lung transplants to 3,404 from 1,947 (Figure OV 5 and Figure OV 6). Intestine transplants have remained relatively stable (97 in 2024 versus 109 in 2013), while pancreas transplants have decreased more noticeably (847 in 2024 versus 1,018 in 2013).

There were a total of 24,013 organ donors in 2024. Of the 16,989 deceased donors, 9,705 were from donation after brain death (DBD) and 7,284 were from donation after circulatory death (DCD). There were 7,024 living donors in 2024. Overall, the percentage of transplants with DCD donors has increased substantially across deceased donor organ type, likely reflecting advancements in deceased donor recovery and preservation. In roughly the past decade, DCD kidney transplants, still the most common DCD organ transplant, had a 190.8% increase: 30.5% in 2024 compared with 10.5% in 2013 (Figure OV 9). Transplants with DCD hearts increased to 17.1% in 2024, from 0 (0%) in 2013. The most dramatic increases were in liver and lung transplant. Representing a 457.5% increase, DCD liver transplant was at 26.7% in 2024 (nearly as high a proportion as for kidney transplants), compared with 4.8% in 2013. Similarly, DCD lung transplant had a 622.3% increase: 13% in 2024 versus 1.8% in 2013.

3 Trends in Organ Nonuse

While the total number of deceased donors has increased to 16,989 in 2024, from 12,590 in 2020 (2020 Annual Data Report), the percentage of organs recovered for transplant but not transplanted (nonuse) has also increased, most notably among deceased donor kidneys. (Note that nonuse differs from nonutilization. In nonutilization, donors are consented but organs are not recovered, and this is not covered in the Annual Data Report.) In 2024, 29.3% of recovered kidneys were not transplanted, up from 18.2% nonuse in 2013 (Figure OV 7). The increase has also been notable among recovered lungs: 11.3% nonuse in 2024 compared with 6.7% in 2013. The proportion of recovered pancreata not transplanted was higher than for all other organs except kidneys; however, the proportion has remained relatively stable over roughly the past decade: 25.1% in 2024 and 23.9% in 2013. The proportions of livers and hearts recovered but not transplanted have also increased but much less so: 11.6% and 1.9% nonuse in 2024 versus 9.7% and 0.8% in 2013, respectively. Conversely, the proportion of intestines recovered but not transplanted has actually declined to 4.9% in 2024, from 9.9% in 2013.

4 Posttransplant Survival

Five-year unadjusted survival remained substantially higher in kidney, liver, pancreas, and heart recipients compared with lung and intestine recipients who underwent transplant in 2017-2019. At 5 years posttransplant, 85.9%, 81.8%, 89.0%, and 80.6% of kidney, liver, pancreas, and heart transplant recipients were alive, respectively (Figure OV 8). However, only 63.3% and 60.0% of intestine and lung transplant recipients were alive after 5 years, respectively.

5 New in This Year’s Annual Data Report

Several new figures and tables have been added in this 2024 Annual Data Report. All organ-specific chapters now contain tables on donor-recipient infectious disease serology matching, figures on candidate active/inactive status, figures and tables on transport distance from donor to candidate, and figures on transplant center counts. The Kidney, Liver, Heart, and Lung chapters have added information about transplant programs and volumes. The Kidney and Liver chapters now include data on living donors over time. The Pancreas and Lung chapters now provide information about posttransplant survival by DCD status, given the recent use of these organs. The Pancreas chapter now includes data on preservation (ie, cold ischemia) time. The Liver chapter now includes data on transplant rates by diagnosis, trends in exception cases, and trends in multiorgan transplant type. The Intestine chapter has added information about congenital versus noncongenital diagnoses. The Heart chapter now contains information about the use of circulatory devices. Finally, the Lung chapter includes added figures reflecting the new allocation scores.

In August of 2024, the Health Resources and Services Administration (HRSA) provided a critical comment letter to the Organ Procurement and Transplantation Network (OPTN) with subsequent direction to develop an analytic definition of allocation out of OPTN sequence (AOOS), which was finalized in June of 2025. Given this critical comment and analytic definition, the 2025 Annual Data Report will include new data regarding trends in AOOS.

6 Summary

Overall, 2024 data reveal ongoing steady increases in volume; the number of candidates on solid organ transplant waiting lists, number of transplants, and number of recovered organs all continue to reach record levels, reflecting a mix of ongoing improvements as well as persistent challenges in meeting the need presented by patients with organ failure. As more “upstream” data are collected prior to waitlisting, future Annual Data Reports will start to describe the ongoing need in more detail, as the current OPTN data provide limited ability to fully assess the unmet need for organ transplant. The organ-specific chapters that follow provide detailed data as well as data relevant to the different organ systems, as each subspecialty strives to improve access to and outcomes after solid organ transplant. However, this high-level overview demonstrates a complex but growing transplant system in the United States, and presents data that highlight ongoing challenges for the transplant community to address.

Support, Copyright, and Citation Information

This publication was produced for the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), by Hennepin Healthcare Research Institute (HHRI) and the United Network for Organ Sharing (UNOS) under contracts HHSH75R60220C00011/HHSH75R60226C00003 and HHSH250201900001C, respectively.

This publication lists nonfederal resources in order to provide additional information to consumers. The views and content in these resources have not been formally approved by HHS or HRSA. Neither HHS nor HRSA endorses the products or services of the listed resources.

The OPTN/SRTR 2024 Annual Data Report is not copyrighted. Readers are free to duplicate and use all or part of the information contained in this publication. Data are not copyrighted and may be used without permission if appropriate citation information is provided.

Pursuant to 42 U.S.C. 1320b-10, this publication may not be reproduced, reprinted, or redistributed for a fee without specific written authorization from HHS.

Suggested Citations:

Full citation: Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR). OPTN/SRTR 2024 Annual Data Report. U.S. Department of Health and Human Services, Health Resources and Services Administration; 2026. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Abbreviated full citation: OPTN/SRTR 2024 Annual Data Report. HHS/HRSA; 2026. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Chapter citation: [Authors]. OPTN/SRTR 2024 Annual Data Report: [chapter]. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Chapter citation for AJT e-supplement available at amjtransplant.org: [Authors]. OPTN/SRTR 2024 Annual Data Report: [chapter]. Am J Transplant. 2026;26([issue and suppl numbers]):[page range]. [doi]

Publications based on data in this report or supplied on request must include a citation and the following statement: The data and analyses reported in the OPTN/SRTR 2024 Annual Data Report have been supplied by the United Network for Organ Sharing and Hennepin Healthcare Research Institute under contract with HHS/HRSA. The authors alone are responsible for reporting and interpreting these data; the views expressed herein are those of the authors and not necessarily those of the U.S. government.

This report is available at https://srtr.transplant.hrsa.gov/annualdatareports. Individual chapters, as well as the report as a whole, may be downloaded.

List of Figures

Figure OV 1: All candidates on the kidney or liver waiting list
Figure OV 2: All candidates on the waiting list for organs other than isolated kidney or liver
Figure OV 3: New candidates added to the kidney or liver waiting list during the year
Figure OV 4: New candidates added to the waiting list during the year for organs other than isolated kidney or liver
Figure OV 5: Total counts of kidney or liver transplants
Figure OV 6: Total counts of transplants for organs other than isolated kidney or liver
Figure OV 7: Percentages of organs recovered for transplant and not transplanted
Figure OV 8: Patient survival among all transplant recipients, 2017-2019, by organ
Figure OV 9: Percentages of DCD transplants by organ

**All candidates on the kidney or liver waiting list.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year.

Figure OV 1: All candidates on the kidney or liver waiting list. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year.

**All candidates on the waiting list for organs other than isolated kidney or liver.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year. PAK, pancreas after kidney; PTA, pancreas transplant alone.

Figure OV 2: All candidates on the waiting list for organs other than isolated kidney or liver. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year. PAK, pancreas after kidney; PTA, pancreas transplant alone.

**New candidates added to the kidney or liver waiting list during the year.** A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at multiple centers are counted once per listing. Active and inactive patients are included.

Figure OV 3: New candidates added to the kidney or liver waiting list during the year. A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at multiple centers are counted once per listing. Active and inactive patients are included.

**New candidates added to the waiting list during the year for organs other than isolated kidney or liver.** A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at multiple centers are counted once per listing. Active and inactive patients are included. PAK, pancreas after kidney; PTA, pancreas transplant alone.

Figure OV 4: New candidates added to the waiting list during the year for organs other than isolated kidney or liver. A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at multiple centers are counted once per listing. Active and inactive patients are included. PAK, pancreas after kidney; PTA, pancreas transplant alone.

**Total counts of kidney or liver transplants.** Retransplants and multiorgan transplants are included. Kidney: patients undergoing kidney or simultaneous pancreas-kidney transplant.

Figure OV 5: Total counts of kidney or liver transplants. Retransplants and multiorgan transplants are included. Kidney: patients undergoing kidney or simultaneous pancreas-kidney transplant.

**Total counts of transplants for organs other than isolated kidney or liver.** Retransplants and multiorgan transplants are included. Heart: patients undergoing heart or heart-lung transplant. Lung: patients undergoing lung or heart-lung transplant. Pancreas: patients undergoing pancreas or simultaneous pancreas-kidney transplant.

Figure OV 6: Total counts of transplants for organs other than isolated kidney or liver. Retransplants and multiorgan transplants are included. Heart: patients undergoing heart or heart-lung transplant. Lung: patients undergoing lung or heart-lung transplant. Pancreas: patients undergoing pancreas or simultaneous pancreas-kidney transplant.

**Percentages of organs recovered for transplant and not transplanted.** Percentages of organs not transplanted out of all organs recovered for transplant. Kidneys and lungs recovered en bloc are counted once, and those recovered separately are counted twice.

Figure OV 7: Percentages of organs recovered for transplant and not transplanted. Percentages of organs not transplanted out of all organs recovered for transplant. Kidneys and lungs recovered en bloc are counted once, and those recovered separately are counted twice.

**Patient survival among all transplant recipients, 2017-2019, by organ.** Patient survival estimated using unadjusted Kaplan-Meier methods. Similar overall survival rates for kidney and pancreas recipients and liver and heart recipients may obscure an organ's line on the graph.

Figure OV 8: Patient survival among all transplant recipients, 2017-2019, by organ. Patient survival estimated using unadjusted Kaplan-Meier methods. Similar overall survival rates for kidney and pancreas recipients and liver and heart recipients may obscure an organ’s line on the graph.

**Percentages of DCD transplants by organ.** All transplants, including retransplant and multiorgan. DCD, donation after circulatory death.

Figure OV 9: Percentages of DCD transplants by organ. All transplants, including retransplant and multiorgan. DCD, donation after circulatory death.