The structure and effectiveness of the U.S. organ procurement system.

Despite the overall success of the U.S. organ procurement network, local success rates vary widely, from three kidneys procured for transplantation per million population in some areas to 40 per million in others. Of the two kinds of organ procurement agencies (OPAs) that operate within the network--independently organized and hospital based--the former are more successful. In this study, I analyze the organizational characteristics of the two kinds of OPAs in an attempt to account for their differing success rates. I found that organ procurement appears to require an effective program of "medical marketing," that is, a commitment to convincing medical professionals in intensive care units to refer potential donors to an OPA.