Too Many People Die Waiting for Organ Transplants. Can a Grantmaker Change That?

If you're not paying close enough attention, the Laura and John Arnold Foundation can seem like a pretty scattered funder, funding grants for work on a grab bag of issues. One month it's disrupting the college textbook industry, the next it's taking on inflated prescription drug prices. Arnold has its fingers in a growing number of pies—the latest being organ transplants. (More about that in a minute.)

Yet, rest assured, there's actually logic tying all these efforts together. Namely, the Arnold Foundation is an opportunitistic funder that's looking for inefficiencies, underperformance and system failures in U.S. society where it can intervene with targeted work that will improve the situation.

Organ transplantation is the latest problematic corner of U.S. society that the foundation sees as ripe for an overdue fix.

Nobody likes to be stuck on a wait list, but the people who have it toughest are those in need of a kidney, heart or other critical organ for transplant. Unfortunately, the nation's organ waiting list continues to grow —there are currently more than 120,000 names on it—while the supply of available organs stays flat.

This supply-and-demand imbalance translates to average waits of three to five years for transplant patients. Not everyone makes it: Twenty-two die every day while on that list. And it's often an expensive wait, requiring costly and less healthy stopgap measures like dialysis.

So recently the Laura and John Arnold Foundation announced two new grant programs to eliminate the wait and get patients the organs they need.

The $4.2 million Donor Management Research Initiative will support efforts to increase the number of organs each donor can give from an average of three up to as many as eight. The grant program, in partnership with Oregon Health and Science University, University of California San Francisco, and United Network for Organ Sharing.

The second grant program will attack the problem of donated but unused organs—about one in five donated organs go unused. In partnership with American Society of Transplantation and the American Society of Transplant Surgeons, LJAF will fund research to evaluate and reshape the country's current organ transplant system, including incentives.

Most of LJAF's work is in justice, education, policy, research integrity and sustainable public finance. But health is a major interest, too. The foundation has not only given more than $40 million for research into nutrition and problems of obesity, but has also been giving grants lately to address problems in the U.S. healthcare system. Laura Arnold is on the board of trustees of the Baylor College of Medicine.

Organ transplantation is pretty advanced medical work, requiring specialized teams of doctors, surgeons and other caregivers. But managing the scarce and time-sensitive supply of donor organs is also a practical and logistical challenge. And that falls within LJAF's wheelhouse and broader mission to identify and improve areas that underperform because of inefficiency, lack of information and similar systemic weaknesses.