Take Vincent Errico of New York, for example. Errico has been on the waiting list for a liver transplant at New York University Medical Center for a week. And if he doesn't receive a transplant soon, he will die. As with hundreds of others hoping for a transplant, his best hope is for an organ from within the state of New York.
Some wait a day, some wait weeks, and some never get one at all.
Right now, organs are allocated by region, and sometimes the sickest people must wait longer because of geography.
"I don't think an organ belongs to me or to you," says Dr. Lewis Teperman, a member of the board of the National United Organ Sharing Network, known as UNOS.
The federal government is requiring UNOS to change the way it distributes organs, starting with livers. Under the orders, UNOS was supposed to outline changes to its distribution system this week. But the network has asked the government for more time.
Currently organs are distributed within about 60 local zones on a priority basis. The "local first" rules mean less medically urgent patients often receive transplants, while a person in a more urgent case, who could better make use of the transplant, but living far away, dies, according to the government.
At the same time, Wisconsin Gov. Tommy Thompson is expected to file suit Monday to prevent the federal plan from taking effect. Wisconsin has a very high organ donation rate - 30 transplants per million compared with the national average of 21 per million - and the governor is worried that his state's organs will be siphoned off to other regions.
Many disagree vehemently with Thompson. One of those is Dr. Jean Edmond of New York Columbia Presbyterian Hospital who says that many people needlessly die waiting for organs that go to patients not as sick.
Whatever changes are implemented, however, they will not solve the underlying shortage of organs.
"We need more people to donate," Teperman says.