OPTN Statement Regarding Deceased Donor Kidney Allocation
Recent events have created public and media interest in the allocation of kidneys from deceased donors and whether there may be exceptions to the allocation waiting list based on compassionate grounds.
According to federal law, organ procurement organizations are responsible for allocating organs based upon established medical criteria. The scope and operating principles of OPTN organ allocation policy are established in the OPTN Final Rule and are designed to ensure equity in organ allocation for all candidates. Among the key provisions of the Final Rule are that organ allocation priority shall be based on sound medical judgment, shall seek to achieve the best use of donated organs, and shall be based as much as possible on objective and measurable medical criteria.
Guided by these principles, OPTN Policy 3.5 addresses the allocation of deceased donor kidneys for the nearly 93,000 candidates listed for a kidney. The policy prioritizes kidney candidates on factors such as the degree of biological match with a donated organ, the amount of time candidates have waited for a transplant, and whether the candidate faces a potential medical disadvantage based upon youth, immune system sensitivity or having been a prior living donor.
Policy does allow an organ procurement organization the authority to use medical judgment, by cooperative agreement with local transplant centers, in awarding additional priority to a kidney transplant candidate who is medically urgent. One common example of medical urgency would be when a kidney candidate has lost all access for life-sustaining dialysis.
However, no OPTN policy provides for exceptions to the waiting list based on compassionate grounds. While it is our goal and wish to provide timely transplantation for all candidates, OPTN policy does not grant authority for a subjective allocation decision based on criteria not supported by medical evidence.