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Coming soon: Change to the Organ Offer Acceptance Limit

Coming soon: Change to the Organ Offer Acceptance Limit

Implementation date

May 29, 2024


The OPTN Board of Directors approved changes to OPTN Policy 5.6.C (Organ Offer Acceptance Limit) on Dec. 4, 2023:

  • The number of offers a transplant hospital may accept per transplant candidate will be reduced from two to one on May 29, 2024. This change applies to all organ types except for pancreas islets.

What you need to do

Transplant hospitals:

  • For any one candidate, the transplant hospital can only have one organ offer acceptance for each organ type.
  • If a transplant hospital receives an offer for a candidate who has already accepted an offer, they must evaluate and determine which offer they consider suitable for their candidate within the policy defined time limits.
  • Transplant hospitals must immediately communicate a refusal reason to the OPO of the previously accepted organ offer if they choose to accept a different offer for the same candidate. 


  • OPOs must continue to extend offers, including primary offers, to candidates who have already accepted another offer.
  • When an organ acceptance for a candidate is declined, the OPO must promptly document refusal reason(s) on the PTR in real-time and not leave the acceptance with the original intended recipient. This ensures that the match accurately reflects the current disposition of the organ.
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