The U.S. organ donation and transplantation system is a vast, interconnected network of specialized medical facilities and infrastructure. A transplant center is a medical facility approved to perform organ transplantation, providing life-saving procedures. The coordination required to manage the national organ waitlist, allocate organs, and ensure patient outcomes necessitates a detailed structure of oversight. Understanding the number of these centers provides insight into the capacity of the nation’s healthcare system to address end-stage organ failure.
The Official Count of Transplant Centers
The current count of accredited transplant centers in the United States is approximately 251 hospitals that perform transplants of at least one organ type. These facilities have met the rigorous criteria to participate in the national system, and the Organ Procurement and Transplantation Network (OPTN) maintains their official registry.
The distinction between a “center” and a “program” is important. The transplant center is the hospital facility itself. A transplant program refers to the specific organ services offered at that facility, such as a kidney or heart program. A single center often houses multiple distinct organ programs, each with specialized teams and operational requirements.
The OPTN, operated by the United Network for Organ Sharing (UNOS), manages this national registry. Centers must be members of the OPTN and abide by its policies to remain active, ensuring consistent data collection and adherence to national standards.
Specialization by Organ Program Type
Not every transplant center performs every type of organ transplant, leading to a high degree of specialization. Centers must maintain separate, accredited programs for each organ they transplant (kidney, liver, heart, lung, pancreas, and intestine). This specialization is necessary due to the unique surgical expertise, post-operative care protocols, and multidisciplinary teams required for each organ type.
Kidney programs are the most common due to the high prevalence of end-stage renal disease. Intestinal and multi-visceral transplant programs are far less common, often concentrated in a few highly specialized centers. Specialized expertise extends to post-transplant care, requiring specific anti-rejection drug protocols and long-term monitoring.
The existence of separate programs means a patient may be eligible for a kidney transplant locally but need to travel for other organs. This focus allows centers to develop deep experience in specific procedures, which helps improve long-term patient and graft survival rates.
Geographic Distribution and Regional Access
The approximately 251 transplant centers are not distributed evenly across the U.S., creating disparities in patient access. Centers tend to be concentrated in major metropolitan areas, leaving patients in rural regions with significant travel burdens. This unequal distribution necessitates patient travel for evaluation, the procedure, and required post-operative follow-up appointments.
The OPTN divides the country into 11 distinct geographic regions for administrative and organ-sharing purposes. While regional boundaries were historically used for allocation, current policies often prioritize minimizing cold ischemia time. The regional structure still influences system governance and local policy development.
The geographic location of the center has practical implications for patients. Waiting list candidates often must temporarily relocate closer to the center as their medical urgency increases. This requirement for travel and lodging adds a considerable logistical and financial layer to the transplant process.
Oversight and Regulatory Standards
The operation of transplant centers is governed by a strict regulatory framework designed to ensure patient safety and quality outcomes. The Centers for Medicare & Medicaid Services (CMS) sets the Conditions of Participation (CoPs) that centers must meet for Medicare and Medicaid reimbursement. These federal requirements establish minimum standards for facility resources, personnel qualifications, and patient care processes.
Compliance with the OPTN’s policies is also a prerequisite for a center to remain active, covering waitlist management and organ allocation protocols. The Scientific Registry of Transplant Recipients (SRTR) provides continuous analysis of center performance, publishing data on patient and graft survival rates.
These metrics are monitored by CMS and the OPTN to identify programs with outcomes that fall outside expected ranges. If a program’s outcomes raise concerns, the center may be subject to review or corrective action, ensuring centers maintain high standards of care.