Dr. Montgomery: The need for transplant organs is much greater than the waiting list
Here is a very interesting interview by Irish reporters of Dr. Robert Montgomery of NYU.
The part I found most interesting was his statement that the need for transplant organs is much greater than the number of people on the waiting list.
“In Ireland, 600 people [are] waiting [for an organ transplant], in the US, 100,000,” Dr Montgomery said.
“But I would challenge that and say that that's a very small percentage of the people who could actually benefit from a transplant.
“So, in the US, only 10% of the people with organ failure ever make it on the list and once on the list, only about 30% of the people ever get an organ.
“If you do the math, we're actually transplanting only about 3% of the people who could benefit from a transplant every year. It's the most highly rationed thing that we do in medicine.”
Dr. Montgomery is talking about transplants of all organs, not just kidneys. But this is a point we have long made about kidney transplants. About 130,000 Americans are diagnosed with kidney failure each year, but only about 25,000 receive a kidney transplant. That’s about 20%. Not all of the other 80% would benefit from a kidney transplant, but most would.
Frank
Here is the whole interview:
Best Of Newstalk
Unlimited pig organs for human transplants 'achievable in our lifetime'
James Wilson
9 Mar 2026
A future in which there are unlimited organs available for transplants is “achievable in our lifetime”, one of the world’s leading surgeons has predicted.
Currently, there are around 600 people waiting for an organ transplant in Ireland, while in the United States the figure is 100,000.
Waiting lists for organ transplants are extremely long due to a shortage of donors. [And the shortage of donors is due to the legal prohibition against compensating donors - Frank.] The result is that many people die before they receive a date for surgery.
However, scientists believe that gene edited pig organs could one day become the default option for people in need of a transplant.
On The Claire Byrne Show, surgeon Dr Robert Montgomery, who himself received an organ transplant seven years ago, predicted it could happen within just a few short years.
“It's already happened,” he explained.
“They're already on the ground, we have gene-edited pigs, we're in a clinical trial now - actually, two clinical trials, one using a 10-gene-edited pig and the other one much more simple, one gene-edited.
“But we also transplant the thymus from the pig to try to reduce the amount of immunosuppression that we need, because the thymus can create something called tolerance, so we can reduce that immunosuppression.
“So, it's a very exciting time for transplantation.”
Currently, the HSE operates a ‘soft-opt out’ system, where the relatives of the deceased are consulted prior to any decision.
People can also opt out while they are alive.
Still, there are not significantly fewer organs donated than there are people in need.
“In Ireland, 600 people [are] waiting [for an organ transplant], in the US, 100,000,” Dr Montgomery said.
“But I would challenge that and say that that's a very small percentage of the people who could actually benefit from a transplant.
“So, in the US, only 10% of the people with organ failure ever make it on the list and once on the list, only about 30% of the people ever get an organ.
“If you do the math, we're actually transplanting only about 3% of the people who could benefit from a transplant every year. It's the most highly rationed thing that we do in medicine.”
Even once an organ is found and successfully transplanted, a patient’s body might reject the organ.
In the case of kidney transplant, rejection happens in between 10 and 15% of patients.
It is treated with immunosuppressant medicine but Dr Montgomery predicted this might one day not be necessary with pig to human transplants.
“With human to human transplants, there are about maybe 50 people walking around completely off all of their immunosuppressive medications,” he explained.
“They've received a tolerance procedure, which involves bone marrow from the donor.
“In xenotransplantation, so pig to human transplant, we're able to transplant the thymus from the pig with the organ. The thymus is the gland that educates the immune system.
“So, basically we're re-educating the human recipient to not recognise that pig organ as being foreign.”
Overall, the early evidence suggests humanity is about to enter what Dr Montgomery described as a “new frontier” of organ donation.
“In the future we want to have unlimited organs and no immunosuppression,” he said.
“Those are our two most ambitious goals that I think are achievable in our lifetime.”
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