Twenty years ago, a bold goal galvanized the donation and transplantation community: double organ donation rates and save more lives. That mission united hospitals, organ procurement organizations (OPOs), transplant centers, and healthcare professionals across the continuum. Two decades later, The Alliance commemorates its 20th anniversary by reflecting on that legacy, celebrating remarkable progress, and charting the course toward “The New Next.”
From Breakthrough Collaborative to National Catalyst
In 2003, U.S. Secretary of Health & Human Services Tommy Thompson launched the Organ Donation Breakthrough Collaborative, setting an audacious goal: dramatically increase organ donation by converting 75% of eligible donors – far beyond the national average at the time.
The early Breakthrough Collaboratives dismantled silos among hospitals, OPOs and transplant centers. Teams shared proven best practices, set bold targets and gave one another permission to test, learn and improve. As Susan Gunderson, former CEO of LifeSource and Alliance board member from 2006-2018, later recalled, participants left those meetings “personally touched,” inspired by the understanding that their work directly affected donor families and transplant recipients.
By 2006, leaders recognized that the momentum could not fade when federal sponsorship ended. The Organ Donation and Transplantation Alliance was chartered to institutionalize that spirit of shared learning and collective accountability – formalizing a national community of practice grounded in the principle of “All Teach, All Learn.”
Rediscovering the Past: It Was a Bold Goal That Started It All
The story begins with a bold challenge. In April 2003, U.S. Health & Human Services Secretary Tommy Thompson launched the Organ Donation Breakthrough Collaborative with an audacious goal: to raise the national conversion rate of potential donors to actual donors to 75% – far beyond the existing average of 48%. Rather than setting modest incremental targets, the collaborative’s founders embraced an “all in” mentality.
As Helen Bottenfield, a member of the collaborative leadership team and later executive director of The Alliance (2008-2013), recalled, “To set a bold goal, to step out there and say, ‘we’re not going to try to increase by one percent, we’re going to increase to where 75 percent of the time we convert potential donors to actual donors,’ that’s really stepping out.” She admired the courage to make such bold requests and offers – something the field had not seen before.
“To set a bold goal, to step out there and say, ‘we’re not going to try to increase by one percent, we’re going to increase to where 75 percent of the time we are going to convert potential donors to actual donors,’ that’s really stepping out.”
— HELEN BOTTENFIELD, Collaborative Leadership Team, consultant, Director of the Alliance 2008-2013
Dennis Wagner, a former HRSA director and one of the collaborative’s leaders, noted that this bold vision fundamentally changed the OPO landscape. “The collaborative was the introduction of performance improvement into the OPO business,” he said. It reoriented hospitals, OPOs, and transplant centers toward a common goal and fostered unprecedented cooperation among them. Wagner emphasized that the focus was on doing more of what worked – and trusting that results would follow. This spirit of audacious goal-setting became a central part of The Alliance’s DNA.
“The collaborative was the introduction of performance improvement into the OPO business. It reoriented hospitals, OPOs, and transplant centers toward a common goal and fostered unprecedented cooperation among them.”
— DENNIS WAGNER, former HRSA director and Collaborative Leadership Team
The Breakthrough Collaboratives Laid the Foundation
Before the Breakthrough Collaborative, hospitals, OPOs, and transplant centers often operated in silos, leaving the responsibility for donation performance largely on the OPO serving each hospital. The collaborative model changed this mindset entirely. It established a team approach where hospitals and OPOs worked together and made bold requests of each other to serve donors, families, and recipients better.
Dean Kappel, president emeritus of Mid‑America Transplant and one of The Alliance’s founders and first board chair, described the Collaboratives as nothing short of revolutionary. “The Collaborative was the introduction of performance improvement into the OPO business,” he said. National learning congresses that followed attracted up to 1,800 participants, cementing a shared culture of improvement and demonstrating that dramatic change was possible through collective effort.
These congresses were more than meetings; they were powerful experiences that inspired attendees to drive change. Susan Gunderson, former CEO of LifeSource and early board member, said, “When you were at the Collaborative, you couldn’t walk away from that meeting without being personally touched – that you can make a difference. People’s lives literally are on the line because of what we do.” The Collaboratives developed best practices that quadrupled the growth rate of organ donation between 2003 and 2006 and transformed the way hospitals and OPOs approached the challenge.
“When you were at the Collaborative, you couldn’t walk away from that meeting without being personally touched.”
— SUSAN GUNDERSON, CEO Emeritus, LifeSource; Alliance Board member, 2006-2018
All Teach, All Learn
One of the most enduring contributions of the Breakthrough Collaborative was the embrace of a pedagogical philosophy championed by Don Berwick and the Institute for Healthcare Improvement (IHI): “All Teach, All Learn.” This approach meant that every participant, whether a surgeon, nurse, administrator, or OPO executive, was both teacher and learner. It reflected a belief in the power of shared knowledge and the idea that continuous improvement was everyone’s responsibility.
Howard Nathan, former President and CEO of the Philadelphia-based Gift of Life Donor Program and an original Alliance board member, credited IHI with bringing credibility to this approach and highlighted its significance. “The Institute’s involvement was extremely important for the credibility of the Collaboratives,” he said. “They actually have a methodology for ‘all teach, all learn,’ and they brought all the people together, believing that things can change. You have to believe that things can change.”
Bottenfield echoed the sentiment, noting that the collaborative experience changed hearts and minds. “It was work that changed hearts and minds,” she said. “Bringing community and national partners to the table helped all of us to see how your work affected my work and my work affected somebody else’s work. I think it gave everyone a kind of permission to fail; to try new things and see what the outcome would be and learn from those failures, rather than being afraid of failure.” This culture of shared learning, permission to innovate, and belief in continuous improvement became part of The Alliance’s core values.
“You have to continue to have this enthusiasm to try to improve people’s lives. If you don’t have that enthusiasm and thirst for knowledge, you go stale and then things don’t change and things don’t improve. So I believe The Alliance is a key component in the continuous improvement of donation and transplantation in the field.”
— HOWARD NATHAN, Former President and CEO, Gift of Life Donor Program; 18-year Alliance Board member
A Sense of Urgency
The Breakthrough Collaborative was not only about collaboration and learning. It also instilled a sense of urgency that still animates The Alliance today. As Jan Finn, President and CEO of the Midwest Transplant Network and a former collaborative faculty member, recalled, participants were encouraged to act quickly and decisively. “We still talk about ‘what are you going to do by Tuesday’,” she said. “There was a desire for quickness. And don’t wait around because we need to produce results.”
Bottenfield reinforced this ethos with a vivid recollection: “The mantra when we would leave a meeting on a Friday was, ‘What are you going to do by Tuesday?’ So it wasn’t, ‘What are you going to do by the end of the quarter?’ It was, ‘What are you going to do before the end of next week?’ And believe it or not, people made it happen.” This immediate, action-focused mindset pushed teams to implement changes rapidly, measure results, and iterate.
National organizations amplified this sense of urgency. The Joint Commission, for example, added a question about organ donation rates to its hospital review survey, encouraging hospitals to prioritize donation performance. Such moves underscored the mission’s seriousness and reinforced the expectation that improvement must be ongoing. This culture of quick action and continuous improvement remains a hallmark of The Alliance’s work today.
From Collaborative to Alliance
As the federal Breakthrough Collaboratives began to wind down, leaders who had experienced their impact were determined to sustain the momentum.
Dennis Wagner advocated for formalizing the Leadership Coordinating Council into a permanent organization. “I did everything I could to encourage this discussion about formalizing the Leadership Coordinating Council into what became The Alliance,” he recalled.
Kappel shared that conviction. “How do we keep this work going… where hospital leaders, transplant surgeons, neurointensivists and OPO professionals are all at the same table?” he asked. He went on to raise nearly $2 million from OPOs across the country to establish The Alliance.
On February 21, 2006, the Organ Donation and Transplantation Alliance was officially chartered – not simply as a successor to the Collaboratives, but as their institutional embodiment. Its purpose was clear: preserve the spirit of shared accountability and accelerate progress nationwide.
“The work of The Alliance is always designed to try to educate, increase collaboration and drive improvement across the entire system.”
— DEAN KAPPEL, President Emeritus, Mid-America Transplant; a founder and first board chair of The Alliance
Mentorship and Collaboration
Mentorship and collaboration, essential tenets of the Breakthrough Collaborative, remain central to The Alliance’s identity. Many leaders from the original Collaboratives emphasized that the experience exposed them to mentors they would not otherwise have encountered.
Charlie Alexander, President and CEO of Infinite Legacy, stated, “You would not have had the opportunity to have mentors at the level that we did as OPO CEOs if it weren’t for the Collaboratives, and if it weren’t for The Alliance driving the collaborative model forward.”
The Collaboratives provided OPO leaders access to leaders, surgeons, and experts from across the country, creating relationships that continue to influence their work.
Dr. Magee observed that while the board of directors provides high-level governance, the real work is done in The Alliance’s Leadership Councils. “A lot of it happens in the leadership councils, which provide an opportunity for many people to get engaged in making a difference,” he said. These councils bring together practitioners from different disciplines and ensure that diverse voices are heard, fostering continual learning and innovation.
“A lot of it happens in the leadership councils, which provide an opportunity for many people to get engaged in making a difference. These councils bring together practitioners from different disciplines and ensure that diverse voices are heard, fostering continual learning and innovation.”
— JOHN MAGEE, MD, Jeremiah & Claire Turcotte Professor of Transplant Surgery at the University of Michigan and 2024 Alliance Board Chair
Building the Future
Over the past five years, The Alliance refined its strategic plan under the leadership of Executive Director Karri Hobson-Pape. The process incorporated structured feedback from the community, consultation from The Joint Commission, and use of a priority payoff matrix to evaluate new initiatives against impact, feasibility and mission alignment.The result was not simply an updated strategy document. It was a deliberate recalibration of how The Alliance serves as a convener, catalyst and connector across the donation and transplantation continuum, ensuring its Vision, Mission and Strategic Pillars function as operational drivers, not aspirational language.
A Message, Brand and Strategy that Resonates
In 2020, The Alliance undertook a thoughtful brand refresh to better align its external identity with its mission and the evolving needs of the donation and transplantation community. Building on its foundation following the Organ Donation National Breakthrough Collaboratives, the organization introduced a bold new visual identity that emphasized unity across three core “estates” – donor hospitals, organ procurement organizations and transplant centers – while reinforcing forward progress and service.
The updated visual identity reflected a collaborative, resilient and future-focused community committed to advancing best practices and supporting patients and donors nationwide. The phased rollout, including a newly designed website, refreshed event materials, updated publications and strengthened digital presence, signaled a renewed commitment to clarity, accessibility and collective impact.
“This was more than a logo change; it was a moment of clarity for our community,” says Paul Myoung, Vice President and Chief Operating Officer of Adult Services at UCSF Health and 2021 Alliance Board Chair. “Healthcare was facing extraordinary strain during COVID, and the donation and transplantation system was being tested in new ways. As we reflect on 20 years of The Alliance, that refresh marked a pivotal moment. It reinforced that we are unified across hospitals, OPOs and transplant centers – steady in purpose, aligned in mission and committed to moving forward together to save and heal lives.”
“This was more than a logo change; it was a moment of clarity for our community. Healthcare was facing extraordinary strain during COVID, and the donation and transplantation system was being tested in new ways. As we reflect on 20 years of The Alliance, that refresh marked a pivotal moment. It reinforced that we are unified across hospitals, OPOs and transplant centers – steady in purpose, aligned in mission and committed to moving forward together to save and heal lives.”
— PAUL MYOUNG, MHA, FACHE, Vice President and Chief Operating Officer of Adult Services at UCSF Health and 2021 Alliance Board Chair
Mission, Vision and Values: A Guiding Framework
From its inception, The Alliance has been dedicated to sharing effective community practices by bringing diverse voices to tackle a wide variety of challenges. Today, the Alliance defines itself with a mission, vision, and core values that have evolved alongside the field:
- Vision: Igniting bold advancements in organ donation and transplantation.
- Mission: Uniting the organ donation, transplantation and healthcare community to promote collaboration, cascade innovations and share effective practices for the benefit of restoring lives through transplantation.
- Value: Developing relevant, collaborative exchanges and scalable learning solutions by activating collective expertise through the “All Teach, All Learn” approach.
These principles translate into three strategic pillars that guide every program and initiative:
- Driving Solutions through Community Collaboration: Identifying and implementing solutions via collaboration among thought leaders.
- Sharing Innovation through Enhanced Learning Programs: Providing effective practices, emerging ideas and interdisciplinary perspectives through engaged learning.
- Delivering World‑Class Experience with Sustainable Infrastructure: Building infrastructure for long‑term success and ensuring world‑class experiences.
Creating a World-Class Learning Management System
As the profession evolved, so too did expectations for how education should be delivered. The Alliance invested in building a modern, scalable Learning Management System (LMS) designed to serve professionals across roles, disciplines and experience levels.
Rather than relying solely on traditional in-person convenings, The Alliance built a digital infrastructure capable of hosting on-demand learning pathways, role-specific modules, resource libraries and archived programming. This shift ensured that quality improvement leaders, transplant administrators, clinical staff, OPO professionals and hospital partners could access relevant, practical education when and where they needed it.
The LMS became the backbone for expanded offerings such as structured on-demand Learning Pathways, quality toolkits, DCD educational resources and evolving guidance related to system modernization. It also strengthened The Alliance’s ability to cascade effective practices rapidly across the community – a direct extension of the original Breakthrough Collaborative ethos.
“Hope is our currency,” says Kevin Myer, President & CEO of LifeGift and 2021 Alliance Board Chair. “Over the past two decades, The Alliance has shown what happens when people rally behind a common cause and are willing to think differently. Building a world-class learning platform wasn’t just a technology upgrade; it was a strategic commitment to scale impact. As we celebrate 20 years, our challenge is to remain bold, to embrace new tools and new technologies while staying grounded in our mission of offering hope and saving as many lives as possible.”
“As we celebrate 20 years, our challenge is to remain bold, to embrace new tools and new technologies while staying grounded in our mission of offering hope and saving as many lives as possible.”
—KEVIN MYER, President & CEO of LifeGift and 2021 Alliance Board Chair
Strategic Learning Portfolio
In parallel with strengthening its infrastructure, The Alliance sharpened its learning portfolio to focus on high-impact opportunities across the donation and transplantation continuum.
Rather than reacting to trends, the organization uses structured community feedback, environmental scanning and disciplined prioritization to identify where aligned effort can generate measurable growth.
Recent focus areas have included:
- Donation after circulatory death (DCD) expansion
- Normothermic regional perfusion (NRP)
- Machine preservation and organ perfusion technologies
- Organ transportation and logistics optimization
- Pediatric donation and transplantation growth
- National system modernization and policy reform
- Financial sustainability and payer engagement
These are not isolated sessions. They are coordinated learning arcs that span educational guides, workshops, collaboratives, insight publications and executive dialogue designed to translate innovation into practical application.
“Innovation must be anchored in reflection,” says Dr. Ana Hands, Vice President of Tulane Transplant Institute and 2022 Alliance Board Chair. “As we mark 20 years, we are reminded that progress requires both courage and discipline. Listening to the community, and acting decisively, allows us to advance in ways that are strategic, inclusive and responsive.”
“As we mark 20 years, we are reminded that progress requires both courage and discipline. Listening to the community, and acting decisively, allows us to advance in ways that are strategic, inclusive and responsive.”
—ANA HANDS, MD, Vice President of Tulane Transplant Institute and 2022 Alliance Board Chair
Enhancing Communications to Meet Professionals Where They Are
Recognizing that the modern professional consumes information differently than even five years ago, The Alliance significantly enhanced its communications strategy.
Through expanded digital newsletters, Insight Series publications such as the Transplant Quality Corner and Illuminating Innovation, T&D Talks, Stories That Honor the Purpose, case studies and social media engagement, The Alliance has broadened its reach and strengthened its ability to disseminate timely information.
This approach ensures that professionals do not need to wait for an annual meeting to access emerging ideas. Whether through short-form insight briefs, leadership spotlights, policy updates or targeted email campaigns, The Alliance has created multiple entry points for engagement.
“The bold goal we set two decades ago ignited a fire that still burns,” says Jan Finn, President & CEO of Midwest Transplant Network and 2023 Alliance Board Chair. “But urgency today looks different than it did in 2006. We must communicate faster, share data more effectively and ensure that professionals have actionable insights in real time. As we reflect on 20 years, I see a field that is more connected and more informed than ever. The Alliance’s ability to meet people where they are – and still challenge them to do more by Tuesday – is part of what keeps our trajectory moving upward.”
“As we reflect on 20 years, I see a field that is more connected and more informed than ever. The Alliance’s ability to meet people where they are – and still challenge them to do more by Tuesday – is part of what keeps our trajectory moving upward.”
— JAN FINN, President & CEO, Midwest Transplant Network and 2023 Alliance Board Chair
Signature Events that Directly Address Current Opportunities
If the learning portfolio defines priorities, The Alliance’s signature events are where strategy meets practice.
The National Critical Issues Forum – its flagship signature event – and the National Collaboration Forum convene surgeons, hospital executives, transplant administrators, OPO leaders, policymakers and industry innovators for candid, cross-disciplinary dialogue.
These gatherings are designed not for passive presentation, but for engagement. CEO roundtables, organ-specific breakouts, applied case discussions and focused working sessions create space for alignment, accountability and forward motion.
Special topic forums and summits – including the National Pediatric Donation and Transplantation Summit – allow the community to converge around emerging opportunities at critical moments.
“At 20 years, The Alliance is not simply hosting meetings,” says Dr. John Magee, Jeremiah & Claire Turcotte Professor of Transplant Surgery at the University of Michigan and 2024 Alliance Board Chair. “It is shaping the trajectory of innovation in our field – convening the right leaders at the right time to tackle real challenges.”
“At 20 years, The Alliance is not simply hosting meetings, it is shaping the trajectory of innovation in our field – convening the right leaders at the right time to tackle real challenges.”
— JOHN MAGEE, MD, Jeremiah & Claire Turcotte Professor of Transplant Surgery at the University of Michigan and 2024 Alliance Board Chair
Initiatives and Programs that Move the Needle
Beyond education and convening, The Alliance has launched structured collaboratives designed to produce tangible outputs and system-level impact.
These include:
- The Artificial Intelligence Transplantation & Donation Resource Collaborative, accelerating responsible AI adoption
- The Transplant Payer Collaborative, bridging communication between transplant programs and commercial payers
- The National Transplant & Donation Quality Collaborative, working to standardize, educate and elevate quality practices nationwide
Unlike educational programming, these initiatives function as working bodies, aligning stakeholders around measurable objectives, shared frameworks and coordinated action.
“Reflecting on our 20-year journey, I am humbled by the collaborative spirit that has transformed so many lives,” says Jennifer Prinz, President & CEO of Donor Alliance and 2025/2026 Alliance Board Chair. “The Alliance has always been about more than convening. It’s about catalyzing action.”
“Reflecting on our 20-year journey, I am humbled by the collaborative spirit that has transformed so many lives,” says Jennifer Prinz, President & CEO of Donor Alliance and 2025/2026 Alliance Board Chair. “The Alliance has always been about more than convening. It’s about catalyzing action.”
—JENNIFER PRINZ, President & CEO of Donor Alliance and 2025/2026 Alliance Board Chair
Partnering for the Future
At its core, The Alliance’s strength lies in partnership across hospitals, OPOs, transplant centers, policymakers, payers and industry innovators.
Over the past five years, The Alliance has intentionally deepened relationships with national professional societies, regulatory bodies and healthcare systems, ensuring that its work complements – rather than duplicates – other efforts in the field. By serving as an objective convener, The Alliance creates a neutral space for collaboration that transcends organizational boundaries.
As the system continues to modernize and technologies evolve, these partnerships will be essential to scaling best practices nationally and ensuring equitable access to transplantation.
“As we look ahead to the next 20 years, partnership will define our progress,” says Dr. Amit Mathur, Surgical Director of Liver Transplantation at Mayo Clinic and 2027 Chair-Elect of The Alliance Board of Directors. “The complexity of modern transplantation demands interdisciplinary collaboration at a level we have never seen before. The Alliance is uniquely positioned to unite clinical excellence, operational insight and policy awareness. Our responsibility is not only to sustain momentum, but to elevate it, ensuring that innovation translates into measurable growth and lives saved.”
“As we look ahead to the next 20 years, partnership will define our progress. The complexity of modern transplantation demands interdisciplinary collaboration at a level we have never seen before. The Alliance is uniquely positioned to unite clinical excellence, operational insight and policy awareness. Our responsibility is not only to sustain momentum, but to elevate it, ensuring that innovation translates into measurable growth and lives saved.”
—AMIT MATHUR, MD, Surgical Director of Liver Transplantation at Mayo Clinic and 2027 Chair-Elect of The Alliance Board of Directors.
Sustained Progress and Growing Impact
The Alliance’s evolution has coincided with historic growth in donation and transplantation. When it launched in 2006, there were 8,017 deceased donors nationwide. That number reached a record 16,989 deceased donors in 2024 – marking an increase of more than 112%. Donation after Circulatory Death (DCD) donors also grew from 642 in 2006 to 8,133 in 2025, contributing to a record 49,065 transplants in 2025.
These milestones reflect extraordinary progress, but they also underscore the work ahead. Tens of thousands of individuals still await lifesaving transplants, and growth must continue.
The New Next
A refined Strategy and 2026 Theme
Looking forward, The Alliance embraces the theme “The New Next: The Future Demands Better.”
This theme acknowledges the remarkable gains achieved but underscores that better is not a destination; it’s a mandate. In an era of advanced analytics, real-time organ tracking, policy reform, and AI‑driven insight, the community must adapt quickly to maximize donation opportunities and operational fairness.
A Call to Action
The Alliance’s 20-year journey demonstrates that bold goals inspire sustained action. From doubling donation rates in the early 2000s to surpassing 49,000 transplants in 2025, progress is undeniable – but so is the responsibility to do more.
At the heart of that progress is mentorship.
From the earliest Breakthrough Collaboratives to today’s leadership councils and national forums, mentorship has been a defining tenet of The Alliance’s community of practice. Experienced leaders opened doors, shared hard-earned lessons and challenged the next generation to think bigger, move faster and lead with purpose. That culture of “All Teach, All Learn” continues to shape careers and save lives.
To commemorate The Alliance’s 20th Anniversary, we invite you to honor the mentors who have influenced your journey in organ donation and transplantation. Through a commemorative contribution, you may honor your mentors in a dedicated section of The Alliance’s website, celebrating their impact and extending their legacy.
Because progress in this field is never the work of one individual. It is the product of shared wisdom, courageous leadership and relationships that span institutions and generations.
As we look toward The New Next, we do so with gratitude for those who guided us – and with renewed commitment to mentor those who will carry this mission forward.
The bold goal lives on through all of us.
Founding Year Steering Committee/Board Members:
- Dean Kappel (President)
- Sue Dunn (Vice President)
- Charles A. Mowll (Secretary)
- Joseph Roth (Treasurer)
- Howard Nathan (Assistant Treasurer)
- Patricia L. Adams, MD
- Anthony D’Alessandro, MD
- Susan Gunderson
- Walter K. Graham, JD
- Sam Holtzman
- Tracy Schmidt
- William C. Schoenhard, FACHE
- J. Richard Thistlethwaite, MD, PhD
- Dennis Wagner
Founding Year Consultants:
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Special Thanks:
We extend our sincere appreciation to Charlie Alexander, Helen Bottenfield, Jan Finn, Susan Gunderson, Dean Kappel, Dr. John Magee, Howard Nathan, Joseph Roth, and Dennis Wagner for dedicating their time and historical knowledge to this story. We also extend our immense gratitude to Theresa Daly and Donna Dickt for their outstanding contributions to the archival research for this project.
Photo Credits:
Helen Bottenfield, Donna Dickt, Jan Finn, Dennis Wagner
