LAURA BARRON-LOPEZ: Last week, a Massachusetts man who was the first person to receive a genetically modified pig kidney transplant died.

The hospital where he underwent the surgery did not find any indication that his death was linked to the transplant.

But his case again put a spotlight on the organ transplant system and the extraordinary measures being taken to make up for its shortfalls.

Ali Rogin has the latest on what can be done to revamp the nations organ transplant process.

ALI ROGIN: Kidneys topped the list of the most needed organs in the US.

Nearly 115,000 people are currently waiting for a new organ.

But the shortage crisis is nothing new.

Last year, more than 46,000 organ transplants were performed.

But 5,600 people still die each year waiting for an organ.

Barry Friedman is the former executive director of the AdventHealth Transplant Institute.

A hospital specializing in organ donation and transplant.

He's now a part of Guidry and East, an organ transplant consulting firm.

Barry, thank you so much for being here.

What's driving the organ transplant backlog in the US?

BARRY FRIEDMAN, Chief of Strategy, Guidry and East Transplant Consulting: Currently, our wait lists continue to grow.

And as those wait lists grows, we have to ensure that the organs that we are recovering are utilized properly.

In this country right now, the way we distribute organs across the country, we try to get it to the right patient at the right time.

So this may mean putting kidneys on commercial airplanes or charter aircraft to get those kidneys to the patient.

And there truly has been some challenges and delays in getting that done.

We are becoming more efficient.

We're trying to create longer preservation times for these organs so that we can either keep them on controlled ice or machine perfusion.

And there's a lot of technology that has really helped us to improve that.

And I think we'll beginning to see a change in ensuring that we're getting these kidneys transplanted.

ALI ROGIN: And the procurement numbers, though, in this country, don't seem to line up very much with those in other parts of the western world.

In 2020, more than 20 percent of procured kidneys were not transplanted.

So the kidneys were there, but they just didn't make it into bodies.

And those numbers are way higher than those of other countries, particularly in Europe.

So I wonder what explains that disparity.

BARRY FRIEDMAN: When we look at the year 2020 and then the COVID coming on board with kidney allocation, it's critical that we're able to get the right kidney to the right patient.

And we've done a tremendous job increasing the number of organs that are donated in this country, and we're grateful for those donor families and for the staff that work there.

However, we're not able at all times to match the exact kidney to the right patient.

We're getting better at that and some of these kidneys because we really do want to achieve the most number of transplants.

ALI ROGIN: So would you say that is mainly a geographical issue?

I mean, the United States is a big country, and logistically it can be hard to get these organs from point A to point B in a timely manner.

BARRY FRIEDMAN: That's part of the challenge.

We need to move those organs efficiently, and we got to ensure that we are using the right transportation mode, whether it's commercial aircraft or charter aircraft or even occasionally government aircraft, to help support getting these vital organs to the correct hospitals and transplant patients.

ALI ROGIN: There is also a growing body of research and industry opinion that says that the U.S. is actually discarding imperfect organs that still might work well in a transplant.

What do you make of that?

BARRY FRIEDMAN: Again, putting this in the hands of the capable physicians and surgeons that care for these patients is critical.

The challenge that we see is getting the right kidney to the right patient, and we're making better changes in our organ allocation.

We have a very collaborative society in the United States for the 250 plus transplant centers that are equipped to do these organ transplants.

And there is still a learning curve that we're trying to achieve as we see more technology and how we perfuse these organs, how we package these organs until we can get them into the transplant recipient.

So we are making great progress.

ALI ROGIN: And as you mentioned, there are still more reforms to come.

The Biden administration has announced plans to modernize the current transplant system.

They want to break up the responsibilities held by the nonprofit United Network for Organ Sharing, or UNOS, which is the only government contractor to ever operate the US transplant system.

Are those efforts going to help fix things?

BARRY FRIEDMAN: I believe they are, and it's time for improvement.

And I'm hopeful that the lessons we've learned over the last 40 years with the united Network of Organ Sharing, that will take those lessons and incorporate it and bring in the new technologies that are so important.

And the Biden administration, the previous administration, both have been very supportive.

This is a bipartisan issue, and this is one of the areas where I feel our government has done a good job in helping to help fund the necessity of increasing the number of transplants.

ALI ROGIN: What does need to change, in your view?

You said that there was, you know, a lot of margin for improvement.

BARRY FRIEDMAN: So I think as we continue to learn how we can best allocate those organs and get them to the right patient.

What's unique in organ transplant is the physicians and surgeons that have dedicated their careers to doing this.

And this is a fairly young procedure that we're doing.

It really began in the 1960s with kidneys seventies.

We're making tremendous headway in how we can ensure we can get the right kidney to the right patient.

We're doing a much better job in 2024.

Obviously, we still have to work on that number of organs that we're not using.

We try to get away from using the word discard because these families have graciously donated those organs and we're unable to use them, is what we're now saying.

ALI ROGIN: I want to ask also about the racial disparities that seem to persist in kidney donation.

In particular, black people are over three times more likely.

Hispanic people are 1.3 times more likely to have kidney failure than white people.

But white Americans are more likely to have a kidney transplant than either black or Hispanic Americans.

Why is this and what needs to change?

BARRY FRIEDMAN: Obviously, we try to match the genetics.

It's not just the kidney itself.

It's the blood type and the genetic tissue typing that we do, and we try to match that up.

The more blacks, the more Asians, the more that from a racial perspective, we're able to get those kidneys in the pool.

I think we'll see an increase.

We've also learned over the years, as technology has changed, how we diagnose, say, what kidney is acceptable for what patient.

And we're trying to adjust that so we give more points to patients that may be disadvantaged.

ALI ROGIN: That is organ transplant specialist Barry Friedman, thank you so much for joining us.

BARRY FRIEDMAN: Thank you, Ali.