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Revised national kidney transplant allocation system is now in effect

Revised national kidney transplant allocation system is now in effect

Effective December 4, 2014, the national computerized system that matches kidneys from deceased donors with patients needing transplantation has been revised significantly.

Candidates who were listed for a kidney transplant prior to the implementation of the new system will not lose any priority on the waiting list.  The great majority of kidney matches will continue to take place under policies that have been in place for a number of years.  The revised policies are meant to provide additional transplant opportunities for all candidates, and to improve access for specific groups of patients who have traditionally waited longer than average for a transplant.

“The revised system reflects years of study and discussion involving transplant professionals, people personally affected by transplantation, and the general public,” said Carl Berg, M.D., OPTN/UNOS president.  “There is broad consensus that this system preserves the strengths of existing kidney policy while improving it in ways that will help many more people.”

Key goals of the new system include:

  • Extending the length of time kidney recipients may have a functioning transplant
  • Making better use of available kidneys through increasing organ usage and reducing the need for repeat transplants
  • Improving the likelihood of receiving a transplant for candidates who are difficult to match with most donors

To achieve these goals, a number of new and revised policies will be implemented.  Key features of the new system include:

  • Individual calculations of the likely length of function of a donor kidney and of the expected length of time an adult candidate may need a kidney transplant
  • Priority matching of kidneys likely to function the longest with candidates likely to need a kidney for the longest amount of time
  • Revisions to blood type matching to provide more opportunities to candidates with more rare types
  • Increased priority for candidates whose immune system is not compatible with most donor kidneys
  • Calculation of transplant waiting time (a key factor in allocation priority) from the date a patient begins dialysis, even if he or she started dialysis before being accepted for listing at a transplant center
  • Elimination of kidney payback offers and local logistical exceptions to the national system

The OPTN/UNOS Kidney Transplantation Committee will actively study the effects of the newly implemented system and will consider any future revisions or additions to ensure it meets the needs of candidates in the fairest manner possible.

A number of resources are available to help transplant professionals with policy implementation and to help transplant candidates understand the new system.

United Network for Organ Sharing (UNOS) serves as the Organ Procurement and Transplantation Network (OPTN) by contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation. The OPTN brings together medical professionals, transplant recipients and donor families to develop national organ transplantation policy.


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