OPTN/SRTR 2024 Annual Data Report: Vascularized Composite Allograft

D. Spencer Nichols1, Giuliano Testa2, Liza Johannesson2, Jonathan M. Miller3,4, Erin M. Schnellinger5, Ethan Studenic5, Allyson Hart3,4, Jon J. Snyder3,4,6, Linda C. Cendales7

1Division of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC

2Department of Transplant Surgery, Annette C. and Harold C. Simmons Transplant Institute, and the Division of Obstetrics and Gynecology, Baylor University Medical Center, Dallas, TX

3Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN

4Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN

5Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA

6Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

7Department of Surgery, Duke University, Durham, NC

Abstract

This chapter provides a comprehensive summary of data collected over roughly the past decade, beginning in 2014 when vascularized composite allografts (VCAs) were incorporated into the Final Rule and brought under the definition of solid organ transplantation. As in previous years, the number of VCA procedures in the United States remains low, with 55 uterus transplants and 37 nonuterus transplants reported from 2014 through 2024. While the limited volume precludes definitive conclusions, several consistent trends are observed. Among nonuterus VCA transplants, upper limb remained the most common overall, although head and neck transplants were most frequent in 2024. Nonuterus transplants in 2014-2024 were most often performed in recipients aged 18-34 years, with donors typically drawn from the same age range. Trauma remained the leading indication for nonuterus VCA transplant. White and male recipients were the most common recipients of nonuterus VCA transplant. Uterus transplants were most frequently performed in White women aged 18-34 years, typically for congenital indications. From 2016 through 2024, there were 10 reported uterus graft failures, and only one reported failure of a nonuterus graft—in the upper limb category—since 2014. Although the number of transplants and reported graft failures remained relatively low, the field continues to advance through ongoing efforts to develop standardized outcome measures, standardized definitions of graft success and failure, and standard operating procedures in hand and face transplantation. These initiatives are beneficial for improving data comparability, guiding clinical decision-making, and supporting sustained progress in VCA research and patient care.

Keywords: Abdominal wall transplant, face transplant, multiorgan transplant, upper limb transplant, uterus transplant, vascularized composite allograft (VCA)

1 Introduction

In 2014, vascularized composite allograft (VCA) transplantation was incorporated into the Organ Procurement and Transplantation Network (OPTN) Final Rule, bringing it under the same federal oversight and regulatory standards as solid organ transplantation.1,2,3 The Final Rule defines VCA transplantation as the transplant of any body part meeting all of the following nine criteria:

  1. Vascularized and requiring blood flow through surgical vascular anastomosis to function posttransplant;
  2. Composed of multiple tissue types;
  3. Recovered from a human donor as an anatomical or structural unit;
  4. Transplanted into a human recipient as an anatomical or structural unit;
  5. Minimally manipulated (ie, processed in a way that does not alter its original characteristics related to reconstruction, repair, or replacement);
  6. Intended for homologous use (ie, to perform the same basic function in the recipient as in the donor);
  7. Not combined with another article, such as a device;
  8. Susceptible to ischemia and therefore stored only temporarily, not cryopreserved; and
  9. Susceptible to allograft rejection.

Under this definition, the OPTN defines the following anatomical structures as VCAs:

Abdominal wall: including vascularized skeletal elements such as the symphysis pubis;

External male genitalia: including penis and scrotum;

Head and neck: including face (with underlying skeleton and muscle), scalp, trachea, larynx, thyroid, and parathyroid (“head and neck” is the recognized term for this type of transplant both under OPTN definition and as the otolaryngology subspecialty of the American College of Surgeons);

Lower limb: including gluteal region, anterior lateral thigh flaps, toe transfers, and pelvic structures transplanted intact;

Musculoskeletal composite graft segment: such as latissimus dorsi, spine axis, or any vascularized muscle, bone, nerve, or skin flap;

Other genitourinary organs: including external and internal female genitalia (other than cervix, uterus, and vagina), internal male genitalia, and urinary bladder;

Spleen;

Upper limb: including partial or complete limb grafts and radial forearm flaps;

Uterus: including cervix, uterus, and vagina; and

Vascularized glands: including adrenal and thymus.4,5,6

The clinical impact of VCA transplant is considerable, with indications including tissue loss from trauma or congenital absence. It is typically reserved for carefully selected patients for whom traditional reconstructive approaches have been exhausted. Beyond restoring complex tissue architecture and function, VCA transplant can also reestablish critical physiologic capacities such as fertility or expansion of the abdominal domain to accommodate transplant of organs, particularly the intestine.7,8,9,10 Additionally, VCA transplant has been linked to improved self-image, enhanced social reintegration, and reduced posttraumatic psychological distress.11 However, these benefits come with important risks. As with other solid organ transplants, VCA transplant requires lifelong systemic immunosuppression, which carries well-documented adverse effects, risks, and complications. Ongoing efforts aim to adapt immunosuppressive regimens specifically for VCA transplant, drawing from established protocols in solid organ transplantation and integrating emerging evidence.12,13

This chapter presents a comprehensive review of VCA activity in the United States over roughly the past decade, including VCA candidates on or added to the waiting list from the time VCA transplantation fell under the legal purview of the OPTN (July 3, 2014) through 2024, with particular emphasis on the most recent year of data collection. It presents detailed data on VCA transplant candidates, donors, recipients, access to transplant, and posttransplant outcomes. The objective is to offer a current, data-driven resource for both surgical specialists and the broader transplant community.

2 Definitions

Prior to 2023, the date a VCA candidate was added to the OPTN waiting list was not universally reported. In cases where there is not a reported date of addition to the OPTN waiting list, the VCA patient’s listing date is assumed to be their transplant date.

A “transplant center” is a hospital that may have many “transplant programs” for the transplant of specific organ types. At the level of reporting by organ type, as is the case in this chapter, “program” and “center” are used interchangeably.

For the purpose of this report, in this chapter Hispanic refers to individuals reported as Hispanic/Latino without any reported race. Categories including White, Black, Asian, Native Hawaiian, and Native American refer to non-Hispanic individuals. Multiracial includes those reported as multiple races or Hispanic/Latino individuals with at least one reported race (eg, White Hispanic). When shown, the non-White category includes Black, Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and Multiracial individuals or individuals with race unreported. When shown, the Other race category includes any of the categories included in non-White that are not shown in their own separate category.

Posttransplant outcomes are defined hierarchically as died, retransplanted, relisted, patient requested removal, and graft failure as reported on the OPTN Transplant Recipient Registration or Transplant Recipient Follow-up forms. For example, if a patient has died, they are categorized as “died” regardless of whether they previously had retransplant, relisting, requested removal, or graft failure. Similarly, if a patient had not died or undergone retransplant, but was relisted, they are categorized as “relisted” regardless of whether they previously had requested removal or had reported graft failure. If there is a report that a patient requested removal, then the patient is classified as “requested removal” rather than as a graft failure. However, if a center reported a planned removal as a graft failure without indicating that the patient requested removal, this is classified as a graft failure because there is no way to distinguish whether a removal was planned. This distinction should be held in mind when interpreting posttransplant uterus outcomes, as it is possible that reported graft failures may have been planned removals. Pregnancy outcomes from uterus transplant were not systematically collected in the OPTN data until September 2023; therefore, current estimates of live birth outcomes must rely on authors’ personal communications. Note that this definition of graft failure may differ from that under the OPTN Modify Graft Failure Definition for VCA policy, which was implemented on September 14, 2023.14 If there was no report of any other outcome, a patient is categorized as having a “functioning graft.”

3 Uterus Transplant

3.1 Candidates

The first uterus transplant in the United States was in 2016.10 Up until 2019 and the start of the COVID-19 pandemic, the annual number of candidates listed for uterus transplant was steadily increasing (Figure VCA 1). Postpandemic, listings for uterus transplant have rebounded, as has the number of uterus transplants (see the Recipients and Transplants section). Overall, the number of uterus transplant candidates ever waiting during a year rose to 17 in 2024 from 7 in 2016, a 142.9% increase (Figure VCA 1). Because some individuals may appear across multiple years, such annual candidate counts do not reflect unique candidate totals. From 2016 through 2024, there have been a total of 72 listings for uterus transplant (Figure VCA 2).

Most of the 72 uterus transplant candidates have been aged 18-34 years at the time of listing (57 candidates [79.2%]), followed by 35-49 years (15 [20.8%]) (Figure VCA 2). Most of the 72 candidates were White (60 [83.3%]), followed by Black (5 [6.9%]), with 7 (9.7%) being Other race and ethnicity (Figure VCA 3). Among candidates, blood type A was most common (38 [52.8%]), followed by type O (28 [38.9%]), type B (3 [4.2%]), and type AB (3 [4.2%]) (Figure VCA 4).

3.2 Donors

From 2016 through 2024, the majority of uterus donors have been living (37 donors [67.3%]), with the remaining being deceased donors from donation after brain death (DBD) (18 [32.7%]) (Figure VCA 10). The most common age group of donors was 18-34 years (28 [50.9%]), closely followed by donors aged 35-49 years (26 [47.3%]); only a single uterus donor (1.8%) was aged 50-64 years (Figure VCA 11). Decisions about selection of living and deceased donors are highly specific to the small number of centers performing uterus transplant, and, as such, information about donor acceptance decisions remains limited.

3.3 Recipients and Transplants

Of the 72 registrations for uterus transplant in 2016-2024, 55 (76.4%) patients underwent transplant during that period. The highest number of uterus transplants in a single year occurred in 2019, with 12 transplants performed; in 2024, nine were performed (Figure VCA 5). The most common diagnosis for uterus transplant in 2016-2024 was congenital absence of the uterus (38 recipients [69.1%]), followed by unspecified Other causes (7 [12.7%]), trauma (1 [1.8%]), and malignancy (1 [1.8%]); diagnosis data were missing for 8 recipients (14.5%) (Figure VCA 9). The majority of recipients were aged 18-34 years at transplant (40 [72.7%]), followed by those aged 35-49 years (15 [27.3%]) (Figure VCA 6). Most recipients were reported as White (48 [87.3%]), with the remaining in the non-White category (Figure VCA 7). Blood type A was most common among recipients (29 [52.7%]), followed by type O (20 [36.4%]), type B (3 [5.5%]), and type AB (3 [5.5%]) (Figure VCA 8).

3.4 Posttransplant Outcomes

Of the 55 uterus transplants performed in 2016-2024, 10 (18.2%) were reported as failed and there were two relistings (Figure VCA 12). The specific timing and circumstances surrounding reported graft failures are not provided in the OPTN/SRTR 2024 Annual Data Report.

Data regarding live births after uterus transplant remain sparse, with only two live births recorded in OPTN data since collection of data on live births began in late 2023.15 As of August 2025, the authors are aware of individual transplant centers having reported 37 live births in 2016-2024, with 30 women delivering at least one child; seven of these women delivered two children each.

3.5 Access

Through 2024, uterus transplant procedures have been performed in four transplant programs in four states. Texas has performed the highest number, accounting for 35 of the 55 procedures (63.6%) in 2016-2024, followed by Ohio (8 transplants [14.5%]), then by Pennsylvania (6 [10.9%]) and Alabama (6 [10.9%]) (Table VCA 1).

4 VCA Transplant Other Than Uterus

4.1 Candidates

Since the implementation of the Final Rule and initiation of OPTN oversight of VCA transplantation in 2014, the annual number of candidates listed for VCA transplant other than uterus (referred to as nonuterus VCA transplant herein) has remained relatively stable, with minor fluctuations. In 2024, there were 11 overall candidates ever waiting during the year—a slight decrease from 15 candidates in 2023 and 14 candidates in 2014 (Figure VCA 13). Of those 11 candidates, five (45.5%) were waiting for head and neck procedures, three (27.3%) for upper limb, three (27.3%) for abdominal wall, and none (0%) for external male genitalia. Because some individuals may appear across multiple years, such annual candidate counts do not reflect unique candidate totals. Since 2014, there have been a total of 70 unique registrations for nonuterus VCA procedures (Figure VCA 14). Among these, upper limb has been the most commonly pursued transplant type, with 27 candidates (38.6%), followed by head and neck (23 [32.9%]), abdominal wall (17 [24.3%]), and external male genitalia (3 [4.3%]) (Figure VCA 14).

The largest age group of the 70 nonuterus VCA transplant candidates in 2014-2024 was 18-34 years at the time of addition to the waiting list (25 candidates [35.7%]), followed by 50-64 years (20 [28.6%]), 35-49 years (20 [28.6%]), 65 years or older (3 [4.3%]), and younger than 18 years (2 [2.9%]) (Figure VCA 15). Most candidates during that time period were White (52 [74.3%]), followed by Hispanic (9 [12.9%]), Black (7 [10.0%]), and Other race and ethnicity (2 [2.9%]) (Figure VCA 16). Male candidates (49 [70.0%]) outnumbered female candidates (21 [30.0%]) (Figure VCA 17). Among nonuterus VCA candidates, blood type O was most common (32 [45.7%]), followed by type A (25 [35.7%]), type B (11 [15.7%]), and type AB (2 [2.9%]) (Figure VCA 18).

4.2 Donors

Donor data for nonuterus VCA transplant remain sparse, with just 37 individuals recorded since OPTN oversight began in 2014. Young adult donors (aged 18-34 years) were the predominant group in 2014-2024, at over half (20 donors [54.1%]), followed by donors aged 35-49 years (12 [32.4%]) and younger than 18 years (4 [10.8%]); only a single donor (2.7%) was aged 50-64 years (Figure VCA 26).

4.3 Recipients and Transplants

Of the 70 registrations for nonuterus VCA procedures in 2014-2024, 37 patients (57.8%) underwent transplant during that period. In 2024 alone, three transplants were performed (one upper limb and two head and neck), an increase from 2023, which saw only a single transplant (head and neck). The highest number of nonuterus VCA procedures in a single year occurred in 2016, with seven transplants performed: five upper limb, one head and neck, and one external male genitalia (Figure VCA 19).

During 2014-2024, upper limb transplants were the most frequently performed, accounting for 43.2% (n=16) of all 37 nonuterus VCA transplants, followed by head and neck (15 [40.5%]), abdominal wall (4 [10.8%]), and external male genitalia (2 [5.4%]) (Figure VCA 20).

The largest number of the 37 recipients in 2014-2024 were aged 18-34 years at transplant (16 recipients [43.2%]), followed by those aged 50-64 years (10 [27.0%]), 35-49 years (7 [18.9%]), 65 years or older (3 [8.1%]), and younger than 18 years (1 [2.7%]) (Figure VCA 21). Most recipients were reported as White (30 [81.1%]), with the remaining (7 [18.9%]) in the non-White category (Figure VCA 22). Most of the 37 recipients were male (28 [75.7%]) (Figure VCA 23). Blood type O was most common among recipients (17 [45.9%]), followed by type A (11 [29.7%]), type B (8 [21.6%]), and type AB (1 [2.7%]) (Figure VCA 24).

Trauma was the leading diagnosis for nonuterus VCA transplant in 2014-2024, at 14 recipients (37.8%). Other diagnoses included infection (9 [24.3%]), unspecified other causes (3 [8.1%]), burn/explosion injuries (2 [5.4%]), ischemia (1 [2.7%]), and malignancy (1 [2.7%]). Diagnosis data were missing for seven recipients (18.9%) (Figure VCA 25).

4.4 Access and Outcomes

Through 2024, nonuterus VCA procedures have been performed in 12 states (Table VCA 3). Currently, programs in Massachusetts have performed the highest number at 7 of 37 transplants (18.9%) (Table VCA 3). Nationwide, 21 programs have performed at least one nonuterus VCA transplant, with nine programs (42.9%) performing upper limb transplant, seven (33.3%) performing head and neck, three (14.3%) performing abdominal wall, and two (9.5%) performing external male genitalia VCA transplant (Figure VCA 27). Since the publication of the 2022 Annual Data Report, additional nonuterus VCA procedures have been performed in Arizona (its first), as well as in Minnesota, New York, and Pennsylvania (Table VCA 3).

Of the 37 nonuterus VCA procedures performed in 2014-2024, one upper limb graft (2.7%) has been reported as a failure (Table VCA 2). However, the specific timing and circumstances surrounding this graft failure are not provided in this Annual Data Report. This finding is unchanged from the data in the 2022 Annual Data Report.

5 Observations

Over the past decade, VCA transplant in the United States has maintained a relatively low procedural volume. Although missing data entries in the national and centralized database continue to improve, missing data are responsible for ongoing challenges. Since OPTN oversight began on July 3, 2014, there have been 72 candidates registered on the waiting list for uterus VCA procedures and 70 registered on the waiting list for nonuterus VCA procedures, resulting in 55 uterus transplant recipients and 37 nonuterus transplant recipients through 2024. Upper limb remained the most commonly pursued and performed nonuterus VCA transplant type, although recent years have seen a rise in head and neck procedures. In 2024, nine uterus VCA and three nonuterus VCA procedures were performed, which is on par with previous years. Those undergoing uterus VCA transplant are most often young adults aged 18-34 years, White, recipients from a living donor, and with a diagnosis of congenital abnormalities. Those undergoing nonuterus VCA transplant are most often young adults aged 18-34 years, White, and male, with trauma representing the leading indication. These trends are unchanged over the past decade.

The field of VCA transplantation continues to mature in the United States. Areas such as protocol standardization, long-term outcome data, and immunosuppression management remain active focuses of development. The OPTN has continued to refine VCA policy related to allocation,16 data collection,14,15,17 and transplant program requirements.4,18 VCA transplantation stands to benefit from continued OPTN efforts to improve data collection, and focus should remain on efficient data collection that will inform efforts to enhance patient safety and effective donor allocation policy, with particular attention on which fields in the OPTN forms are required or optional. In March 2025, the National Academies of Sciences, Engineering, and Medicine (NASEM) released a report titled Principles and Framework to Guide the Development of Protocols and Standard Operating Procedures for Face and Hand Transplants.19 In brief, the report is organized into Part I (background on VCA), Part II (the transplant experience), and Part III (the future of face and hand transplantation). Part III includes overarching conclusions and recommendations. Based on these findings, the NASEM committee issued the following recommendations aimed at addressing three central priorities: (1) implementing a whole-health approach to care delivered at high-quality transplant centers (ie, comprehensive and supportive care that includes education, shared decision-making, multidisciplinary clinical care, and lifelong support); (2) fostering collaboration within the face and hand transplant community to standardize care management, monitoring, and data protocols throughout all phases of transplantation; and (3) establishing a structured, systematic framework for ongoing research and investigation.19 Topics that warrant priority consideration for research include immunosuppression and immunomodulation focusing on specificity and the prevention of the development of donor-specific antibodies that avoid associated end-organ toxicity, differential diagnosis of rejection, comprehensive patient- and family-centered VCA outcome measurement tools, shared decision-making, patient selection, and rehabilitation regimens.19 The OPTN VCA Transplantation Committee reviewed the NASEM report in April 2025 and was supportive of its recommendations. These recommendations lay a strong and promising foundation for the continued maturation of VCA transplantation, paving the way for improved patient outcomes, greater clinical consistency, continued research, and sustained innovation in the field.

References

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List of Figures

List of Tables




**Number of prevalent uterus candidates.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time during the year.

Figure VCA 1: Number of prevalent uterus candidates. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time during the year.




**Number of uterus candidates by age at listing, 2016-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time.

Figure VCA 2: Number of uterus candidates by age at listing, 2016-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time.




**Number of uterus candidates by race and ethnicity, 2016-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. Other race and ethnicity includes Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported.

Figure VCA 3: Number of uterus candidates by race and ethnicity, 2016-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. Other race and ethnicity includes Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported.




**Number of uterus candidates by blood type, 2016-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time.

Figure VCA 4: Number of uterus candidates by blood type, 2016-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time.




**Number of uterus transplants, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 5: Number of uterus transplants, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Number of uterus transplants by age at transplant, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 6: Number of uterus transplants by age at transplant, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Number of uterus transplants by race and ethnicity, 2016-2024.** All uterus transplants, including retransplant and multiorgan. Non-White race and ethnicity includes Black, Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported.

Figure VCA 7: Number of uterus transplants by race and ethnicity, 2016-2024. All uterus transplants, including retransplant and multiorgan. Non-White race and ethnicity includes Black, Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported.




**Number of uterus transplants by blood type, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 8: Number of uterus transplants by blood type, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Number of uterus transplants by diagnosis, 2016-2024.** All uterus transplants, including retransplant and multiorgan. Congenital refers to congenital absence of the uterus.

Figure VCA 9: Number of uterus transplants by diagnosis, 2016-2024. All uterus transplants, including retransplant and multiorgan. Congenital refers to congenital absence of the uterus.




**Number of uterus transplants by donor type, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 10: Number of uterus transplants by donor type, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Number of uterus transplants by donor age, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 11: Number of uterus transplants by donor age, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Posttransplant outcome counts among uterus transplant recipients, 2016-2024.** All uterus transplants, including retransplant and multiorgan.

Figure VCA 12: Posttransplant outcome counts among uterus transplant recipients, 2016-2024. All uterus transplants, including retransplant and multiorgan.




**Number of prevalent nonuterus VCA transplant candidates by organ type.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time during the year. VCA, vascularized composite allograft.

Figure VCA 13: Number of prevalent nonuterus VCA transplant candidates by organ type. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time during the year. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplant candidates by organ type, 2014-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.

Figure VCA 14: Number of nonuterus VCA transplant candidates by organ type, 2014-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplant candidates by age at listing, 2014-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.

Figure VCA 15: Number of nonuterus VCA transplant candidates by age at listing, 2014-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplant candidates by race and ethnicity, 2014-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. Other race and ethnicity includes Asian, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported. VCA, vascularized composite allograft.

Figure VCA 16: Number of nonuterus VCA transplant candidates by race and ethnicity, 2014-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. Other race and ethnicity includes Asian, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplant candidates by sex, 2014-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.

Figure VCA 17: Number of nonuterus VCA transplant candidates by sex, 2014-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplant candidates by blood type, 2014-2024.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.

Figure VCA 18: Number of nonuterus VCA transplant candidates by blood type, 2014-2024. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list at any time. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by organ type.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 19: Number of nonuterus VCA transplants by organ type. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by organ type, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 20: Number of nonuterus VCA transplants by organ type, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by age at transplant, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 21: Number of nonuterus VCA transplants by age at transplant, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by race and ethnicity, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. Non-White race and ethnicity includes Black, Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported. VCA, vascularized composite allograft.

Figure VCA 22: Number of nonuterus VCA transplants by race and ethnicity, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. Non-White race and ethnicity includes Black, Asian, Hispanic, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Multiracial, and unreported. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by sex, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 23: Number of nonuterus VCA transplants by sex, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by blood type, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 24: Number of nonuterus VCA transplants by blood type, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by diagnosis, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 25: Number of nonuterus VCA transplants by diagnosis, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of nonuterus VCA transplants by donor age, 2014-2024.** Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.

Figure VCA 26: Number of nonuterus VCA transplants by donor age, 2014-2024. Nonuterus VCA transplants, including adult and pediatric, retransplant, and multiorgan. VCA, vascularized composite allograft.




**Number of transplant programs performing VCA transplants by nonuterus organ type, 2014-2024.** All unique transplant programs performing nonuterus VCA transplants by organ type. VCA, vascularized composite allograft.

Figure VCA 27: Number of transplant programs performing VCA transplants by nonuterus organ type, 2014-2024. All unique transplant programs performing nonuterus VCA transplants by organ type. VCA, vascularized composite allograft.