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March 15 policy implementation: Removal of DSA from kidney and pancreas allocation

Published on: Monday, March 1, 2021

The Organ Procurement and Transplantation Network will implement policies to remove donation service area (DSA) and OPTN region from kidney and pancreas allocation, on March 15, 2021, absent Court intervention.

The OPTN has eliminated DSA and region from the allocation systems of all other organ types, and replaced with a distance-based approach. In the new system for kidney and pancreas allocation, the first unit of distribution is no longer DSA and instead becomes a 250 nautical mile circle around the donor hospital.

Additional changes involve allocation of kidneys and pancreata from Alaska and prioritization of medically urgent kidney patients. The policies also change how released kidneys, pancreata, kidney-pancreas and islets are allocated in the new system when the original intended candidate is not able to be transplanted. Find a summary of changes here.

In order to allow kidney transplant programs to pre-enter medical urgency data prior to implementation, a medical urgency data collection period will open March 8. At that time, kidney programs will need to:

  • Review their current medical urgency status exceptions
  • Enter additional data in Waitlistâ„  for candidates who meet the new medical urgency definition
  • Submit supporting documentation

Professional education resources

Resources and trainings for professionals at OPOs, transplant hospitals and histocompatibility labs are available on UNOS Connect.

Find all policy notices and other information in the policy toolkits in the Professional Education section of the OPTN website:

Do you have questions about the implementation?

If you have questions related to the implementation, contact Customer Service at, or call 800-978-4334 from 8:00 a.m. to 7:00 p.m. EST.

For policy-related questions, email

The Organ Center is available around the clock and can be reached at 800-292-9537.