As of early 2019, about 114,000 people in the United States were on waiting lists for organ transplants to prolong their lives.

Of those, about 95,000 people needed kidneys; 13,000 needed livers; and 8,000 needed other organs. (These numbers add up to more than 114,000 people because some people need multiple organs.)

More than 500,000 Americans are currently on dialysis. More than 50,000 people die each year from kidney disease--more th an from car accidents, suicides, or gunshots. Another 40,000 people die from liver disease.

In 2016, the costs of dialysis were, on average , $76,000-$91,000 per patient per year, depending on the type of treatment. The average costs associated with transplant patients were less than half as much: approximately $35,000 a year. Medicare spending for patients with kidney disease was nearly $114 billion in 2016, of which $35.4 billion was for end-stage renal disease and the rest was for chronic kidney disease (the stages before the end stage).

Dialysis has improved over the years, but a kidney transplant still gives a recipient longer life expectancy-- decades longer , for younger people.

The only cure for end-stage renal failure is a kidney transplant. In 2018 around 21,000 transplants were done.

Nearly 70 percent of donated kidneys came from a deceased donor. Almost all the rest were from relatives and friends of the recipients. In 2016, only 223 living donors gave anonymously to people they didn’t know ("nondirected" donations)--the kind of donation that best allows the transplant system to serve the most urgent cases.

The average recipient waits four to seven years to receive a kidney, and about 5,000 people on the list die each year. Thousands of other people with kidney disease never make it onto the list because the odds of finding a kidney for them before they die are considered too low to be worth adding them to the list. A recent estimate incorporating this fact estimates that 43,000 Americans die each year from kidney disease who could have had longer lives had they been able to obtain a tranplanted kidney.

The current system works particularly poorly for minorities : African Americans are three times as likely as whites to have kidney disease. Hispanics and Native Americans are each about 50 percent more likely than whites to have kidney disease. Genetics may be responsible for some of the difference.

Once on dialysis, whites are twice as likely to get a kidney as minorities. Whites are more likely to have relatives who are healthy and a genetic match, and more likely to have the resources to navigate what can be a complex system to maximize their chances of obtaining a kidney.

The story for other organs is broadly similar, though the numbers are smaller. In short, the current system fails many people who need organ transplants.