Organ distribution

Organ distribution

A single allocation framework for all organs

The organ donation and transplantation system in the U.S. has never worked better than it does today. But every day, we work to continuously improve and make the system even more effective and efficient to serve all of the patients waiting for a lifesaving transplant.

The organ donation and transplant community is working together to introduce continuous distribution—a more fair and flexible approach to allocating donated organs to get the right organ to the right patient at the right time. Our policies have always been data-driven, but this new approach applies advanced analytic techniques to create an algorithm that makes every factor in the match run comparable.

The new framework was approved by the Board of Directors in 2018 as a model for future policy development. It will dissolve hard boundaries that exist in the current, category-based system and ensure that no single factor determines a patient’s priority on the waiting list.

Learn more about the continuous distribution framework, a timeline for development, and the impact the framework will have on future policy development for all organ types.

About continuous distribution

In 2018, the Board of Directors approved the Continuous Distribution model for future policy development. It will eliminate edge cases by dissolving hard boundaries and establishing a single allocation framework for all organs.

Organ allocation today

The current way candidates are prioritized on the waitlist ranks them by placing them into categories, including blood type and antibody sensitization.

For example, patients with an identical blood type to the donor are prioritized over patients that have a compatible blood type to the donor, because all things being equal, it’s generally preferable to match identical blood types. However, by placing one category before another, even the most medically urgent patient with a compatible blood type would wait until less medically urgent patients with identical blood types received offers.

A better way

The new framework moves organ allocation from placing and considering patients by categories such as blood type to leveraging big data analytics and considering multiple factors all at once using an overall score that operates on a sliding scale.

The composite score for each patient includes all factors—medical urgency, outcomes, candidate biology and efficiency of organ transport.

Certain factors will have more weight than others, giving them greater influence on the total score. The framework is designed to be easily “tunable.” If data suggests too much emphasis is being placed on one factor and not enough on another, the weights can be increased or decreased for others.

The new system ensures no single factor determines priority for donated organs.