To address the nation's critical organ donation shortage and improve the organ matching and placement process, the U.S. Congress passed the National Organ Transplant Act (NOTA; P.L. 98-507) in 1984. The act established the Organ Procurement and Transplantation Network (OPTN) to maintain a national registry for organ matching. The act also called for the network to be operated by a private, non-profit organization under federal contract.
Following further study and recommendations from a task force commissioned through NOTA, the U.S. Department of Health and Human Services (HHS) solicited proposals in 1986 for the operation of the OPTN.