About Organ Allocation in the United States

This excerpt from an article in the February issue of Transplant Living discusses the current protocol for organ allocation in the United States.

Matching Organs
Under contract with the U.S. Department of Health and Human Services' Health Services & Resources Administration (HRSA), the United Network for Organ Sharing (UNOS) maintains a centralized computer network, UNetSM, which links all organ procurement organizations (OPOs) and transplant centers. This computer network is accessible 24 hours a day, seven days a week, with organ placement specialists in the UNOS Organ Center always available to answer questions.

Within UNet, every organ sharing institution is electronically linked in a secure, real-time environment over the Internet so that donated organs can be placed as quickly as possible. While UNet utilizes the Internet for common access to UNOS members, it employs secure password access to protect confidential medical data.

Matching Donor Organs With Transplant Candidates
When a deceased organ donor is identified, a transplant coordinator from an organ procurement organization accesses the UNet system. Each transplant candidate in the "pool" is matched by the system against the donor characteristics. The system then generates a ranked list of patients, called a "match run," for each organ that is procured from that donor in ranked order according to organ allocation policies. Factors affecting ranking may include tissue match, blood type, length of time on the waiting list, immune status and the distance between the potential recipient and the donor. For heart, liver and intestines, the potential recipient's degree of medical urgency is also considered. Therefore, the UNet system generates a differently ranked list of patients for each donor organ matched.

The organ is offered to the transplant team of the first person on the list. Often, the top transplant candidate will not get the organ for one of several reasons. When a patient is selected, he or she must be available, healthy enough to undergo major surgery and willing to be transplanted immediately. Also, a laboratory test to measure compatibility between the donor and potential recipient may be necessary. If the organ is refused for any reason, the transplant hospital of the next patient on the list is contacted. The process continues until a match is made. Once a patient is selected and contacted and all testing is complete, surgery is scheduled and the transplant takes place...read the complete article at Transplant Living.