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Kidney Allocation System

New policies to remove DSA and region from kidney and pancreas allocation now in effect. Learn more.

In December 2019, the OPTN Board of Directors approved new kidney allocation policies to update how offers in the kidney allocation system (KAS) are sequenced. Instead of match sequencing relying on donation service area (DSA) and OPTN Region, kidney allocation is now based on geographical distance between donor and recipient. Toolkits have been developed for OPO and transplant professionals to learn more about the policies.

Kidney Allocation System (KAS)

The OPTN implemented KAS in December 2014. KAS was developed in response to higher-than-necessary discard rates of kidneys, variability in access to transplants for candidates who are harder to match due to biologic reasons, inequities resulting from the way waiting time was calculated, and a matching system that results in unrealized life years and high re-transplant rates. The aspects of KAS addressing prioritization of transplant candidates, including EPTS, and of assessing donor longevity potential, including KDPI, will not change as a result of policies affecting kidney distribution.

Find instructions related to KAS below.

KAS Featured Reports

KAS two-year analysis (7/2017)

Equity in access report (8/2017)

KAS Instruction

The following professional education about kidney allocation is available on UNOS Connect:

  • KID111: Modifications to Released Kidney and Pancreas Allocation
  • KID112 - Removing DSA and Region from Kidney and Pancreas Allocation
  • KID113 - Medical Urgency Data Collection Period (previously Phase 1)
  • KID114 - Medically Urgent Status for Adult and Pediatric Candidates (previously Phase 2)
  • QLT102D: Notification Limits for Distance-based Allocation
  • QLT103D: Acceptance Criteria for Distance-based Allocation

KAS Policy & Guidance

KAS Patient Resources


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