What is involved in kidney allocation?
The process of allocating a kidney to a recipient is an intricate process. The procuring organization accesses the national transplant computer database, UNet sm , through the Internet or contacts UNOS directly. In either situation, information about the kidney donor is entered into UNet sm and a donor/recipient match is determined for each donated kidney.
All transplant candidates incompatible with the donor for medical factors such as blood type are eliminated from the match list. The match list of potential recipients is then ranked according to objective medical criteria (body habitus, blood type, tissue type, size of the organ, medical urgency of the recipient, time accrued on the waiting list, and distance between donor and recipient). Survival benefit was added as an additional factor in 2015 (see Question 3).
Using the match of potential recipients, the local organ procurement coordinator or an organ placement specialist contacts the transplant center of the highest-ranked patient and offers the organ to that center. If the kidney is rejected, the next potential recipient’s transplant center is contacted. Calls are made to multiple recipients’ transplant centers in succession to expedite the organ placement process until the kidney is placed. Once the kidney is accepted for a patient, transportation arrangements are made and the transplant surgery team is notified.