Katherine Screws's small intestine was destroyed in a May 2022 car crash, leaving her unable to eat and dependent on IV nutrition. Her original hospital predicted a transplant in about six months, but the wait stretched to three years. After an unusual meeting with an organ procurement organization, she learned that transplant centers vary widely in which organs they accept or refuse. She flew across the country to a different hospital and received a new intestine within weeks.
The case highlights broader inefficiencies in the U.S. transplant system. Intestine transplants are especially rare and biologically difficult, with only 88 performed last year versus more than 27,000 kidney transplants. About one in five donated organs go unused, often because no recipient is found in time. For kidneys, a large study found a 16-fold variation in how quickly patients get transplanted depending on the center, partly because some surgeons are more willing to use organs with complex anatomy or from older, sicker donors.
Screws said she wished patients had more clarity about when an organ might match and why organs are declined. New patient-friendly tools are being developed to help people compare waiting times and other characteristics of transplant hospitals. The case shows that patients who do not ask hard questions may wait far longer than necessary, while viable organs continue to go to waste.