The Louisiana Organ Procurement Agency (LOPA) operates the organ and tissue procurement system for the entire state. LOPA is experiencing an increase in referrals and actual donors, with 101 donors realized from 34 hospitals in 1994. From these donors, 398 organs were recovered to provide 275 kidney, liver, heart, pancreas, and lung transplants in Louisiana, and 97 organs were shared for transplant elsewhere. However, consent for donation was refused for 40% of medically suitable donors, creating a loss of 180-200 organs for transplant, many of which would have been lifesaving. Nationwide, the shortage of organs continues to worsen as waiting lists grow. This health care problem continues to generate corrective initiatives, such as "required request" and performance standards for the organ procurement organization. Ranked in the top group of procurement organizations, LOPA is well positioned to meet and help define new federal standards.