The region's leading provider of human organs for transplantation has staked its reputation on finding innovative ways to increase organ availability and shaving precious seconds in delivery. But Mid-America is also a nonprofit charitable organization that acts increasingly like a for-profit enterprise, selling body parts for financial gain and harboring potential conflicts of interest—while exempted from most federal and state taxes. It invests millions of dollars in for-profit ventures and supplies human bone and tissue to firms in which it maintains an ownership stake and leadership role.