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How are patients selected to receive a transplant?

Organ allocation policy in the U.S.

The United Network for Organ Sharing (UNOS) is a non-profit organization that contracts with the federal government’s Department of Health and Human Services to serve as the nation’s organ transplant system. UNOS establishes allocation policy and manages the national transplant waiting list matching donors to recipients 24 hours a day, 365 days a year. The organization’s policies and computerized network match donated organs with transplant candidates in order to save as many lives as possible while providing recipients with the best chance for long-term survival.

For the policies that govern the allocation, procurement and transportation of deceased organs, UNOS follows a collaborative development process that encourages participation by the public and all areas of the transplant community. The process also promotes equity among patients waiting for organs and policy modification to reflect current science and medical practice.

The resulting allocation criteria is programed into the UNOS computer system. Using a combination of donor and candidate medical data—including blood type, medical urgency and location of the transplant and donor hospitals—UNOS’ system generates a rank-order of candidates to be offered each organ. This match is unique to each donor and each organ.

While many factors are used to match organs with patients, only medical and logistical factors are taken into consideration for all organs. Personal or social characteristics such as celebrity status or income do not play a role in transplant priority.

Before an organ is allocated, all transplant candidates on the waiting list that are incompatible with the donor because of blood type, height, weight and other medical factors are automatically screened out. Proper organ size is critical to a successful transplant. For instance, children often respond better to child-sized organs. Although pediatric candidates have their own unique scoring system, children essentially are first in line for other children’s organs.

Geographic location is also taken into consideration. Hearts and lungs have less time to be transplanted, so the radius from the donor hospital is key when allocating those organs.

Factors in Organ Allocation

There are nearly 118,000 people in the U.S. waiting to receive a lifesaving organ transplant, more than 2,500 of which are in our community. Registering to become an organ, eye and tissue donor is quick and easy to do by saying “yes” at the driver license office or Driver Services, or anytime at Donate Life Colorado or Donate Life Wyoming. Deciding to register as a deceased donor could help save the lives of patients waiting for lifesaving transplants. For residents interested in learning more about living donation, please contact one of the local transplant centers listed on our Living Donation resource page.