[Suzuran]

The "supply shortfall" is due to the requirement that the DNA of the organ has to match up with the DNA of the recipient in order for the organ to function and the fact that the organ has a very short "shelf life" when outside of the donor's body. You can't just randomly stuff organs into people and expect a good outcome, and you can't just stockpile them.

Until we can customize the DNA in the organ for the intended recipient and manufacture them on demand with a short lead time, we are going to have some kind of lack of availability issue. Our issues are not a bunch of power-tripping sociopaths sitting on a hoard of organs deciding who lives or dies, they are trying to rapidly identify who is physically close enough and who genetically matches in the hours you have when an organ becomes available, and is there any opportunity for a cascade donation to be brought into the mix (is this organ compatible with someone who has a willing but incompatible donor who is compatible with someone else, and does that person have a willing but incompatible donor, and so on down the line)

(Edit: I have been informed that the paywalled article, which I cannot read, is about a UK system; I am only familiar with the kidney system in the US. This post probably does not reflect UK practice)