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Donor matching system

How the matching system works

First, a transplant hospital evaluates and accepts a patient for a deceased donor transplant. The hospital then lists that patient with the Organ Procurement and Transplantation Network’s (OPTN) national computer network. The network links all donors and transplant candidates.

Organ procurement organizations (OPOs) identify potential deceased donors and get consent for donation.

When the OPO knows what organs are to be matched, it enters information into the OPTN system.

The system then matches the organs with patients in need.

For each organ, the matching program sets the order of people to receive transplant offers.

The rankings are based on objective factors. Each organ type has its own criteria, but common factors are listed below.

Factors that are considered in organ matching Factors that are not considered in organ matching
  • Blood type
  • Tissue type
  • Organ size
  • Donor height and/or weight
  • How urgently the patient needs a transplant
  • How long the candidate has been waiting for a transplant
  • Whether the patient and the donor are older or younger than age 18
  • Distance between donor and transplant hospital
  • Ethnicity
  • Sex
  • Religion
  • Financial status
  • Celebrity status
  • Citizenship

After running the match, the OPO contacts the transplant team caring for the top-ranked patient. This likely will be a person who:

  • Best matches the medical information of the donor organ
  • Is more sick than, or as sick as, other matching patients
  • Has waited longer for a transplant than other matching patients
  • Is listed at a transplant hospital an appropriate distance from the donor hospital

The OPO sends very detailed medical information about the donor and the organ to the transplant team.

The transplant team reviews the information and decides whether to accept or decline the organ offer.

They will consider a number of factors, such as the donor's medical history and the current health of the potential recipient.

If the transplant team turns down the offer, the organ will continue to be offered in the same way for other patients in order of the match.

Once a transplant program accepts an organ offer, they and the OPO will arrange for the organs to be recovered. Surgical teams will come to the donor hospital to remove and preserve the organs.

Once removed, organs are preserved in a cold solution while being transported to the recipient hospital.

Timing is important because organs can only be preserved for a fairly short time between removal from the donor and transplant into a recipient.

Transplant teams prefer the shortest possible preservation time, to offer the best chance of a successful transplant.

Kidneys are usually transplanted within 36 hours after removal from the donor. The liver, pancreas, and intestinal organs are typically transplanted within 12 hours. Hearts and lungs have the shortest preservation time; they are usually transplanted within six hours.

For heart, lung, or liver transplants, the recipient of the organ is usually known before organs are recovered. The transplant team will begin preparing the patient for surgery before the organ arrives.

The kidneys and pancreas can be preserved somewhat longer.

A recipient may not be decided until after these organs are recovered. A lab will do tests to show how well the donor’s immune system matches that of the candidate.

A transplant team will not accept the organ if these tests show that the patient's immune system will reject the organ.

Organ Procurement Organizations (OPOs)

OPOs play a vital role in the matching process. OPOs identify potential deceased donors and get authorization for donation.

The OPO coordinates things, including:

  • Support for the donor family
  • Consent for donation
  • Organ recovery and preservation
  • Transport of organs to the transplant center

OPOs are assigned to provide organ recovery services to hospitals in a specific geographic area.

OPOs are non-profit organizations and, like transplant hospitals, are members of the OPTN. Each has its own board of directors and a medical director on staff who is usually a transplant surgeon or physician.

OPOs employ highly trained procurement coordinators who carry out the organization's mission.

Once contacted by the hospital with a potential donor, OPO staff:

  • Conduct a thorough medical and social history of the potential donor to determine if they can be a donor and what organs can be donated
  • Make sure the decision to donate is based on informed consent
  • Manage the clinical care of the donor once consent for donation is given
  • Enter the donor’s information into the OPTN matching system
  • Arrange the organ recovery process with the transplant team
  • Provide follow-up information to the donor family and involved hospital staff regarding the outcome of the donations

From the time consent is given for donation to the release of the donor's body to the morgue, all costs involved in the organ donation process are billed directly to the OPO.

OPOs also promote organ donation in their community. They hold workshops on organ donation and take part in community health fairs and events.

OPO hospital development staff also work with hospitals to help educate the staff on the donation process and care of the donor family.

To find out about the OPO in your area, go to the Member Directory.

Organ Center

The OPTN operates the Organ Center, which is staffed 24 hours a day, 7 days a week. It assists with the matching, sharing, and transportation of organs.

Organ Center staff will help OPOs and transplant programs with matching donor organs when needed.

They can also help arrange organ transportation and answer other needs or questions OPO or transplant staff may have.

For more information and resources, go to