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Identify Priority Shares in Kidney Multi-Organ Allocation

eye iconAt a glance

Current policy

Candidates are sometimes placed on the waitlist needing multiple organs due to their disease severity. Often times, the multi-organ candidates need a kidney as part of their multi-organ combination. Currently, several policies govern when an organ procurement organization (OPO) must share multiple organs from a donor to a multi-organ candidate versus sharing each organ to candidates only needing one organ. While there are numerous benefits to transplanting multi-organ candidates with organs from one donor, it also limits the number of kidneys available for kidney-alone candidates. The committee is looking for feedback from the community as they explore a future project that would give OPOs more direction on allocating multiple organs to one candidate versus allocating organs singly.

Supporting media


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Project plan

The committee is working to develop a final project in the future that will address the following issues related to kidney multi-organ allocation:

  • If and when kidneys should be offered to kidney-alone candidates before being offered to kidney multi-organ candidates
  • How to determine which kidney should be offered to various kidney multi-organ and single-organ candidates, who have equal priority for offers in current policy
  • How to handle situations in which an organ offer acceptance conflicts with a multi-organ offer required by policy
  • Providing more direction for multi-organ allocation to OPOs while leaving flexibility for the allocation process

Anticipated impact

  • What it's expected to do
    • Provide clarity to OPOs as they allocate organs from a deceased donor
    • Address access to transplant inequities for kidney-alone candidates
  • What it won't do
    • This concept paper will not change allocation policy at this time. The committee is looking for community feedback as they continue working on the project.

Terms to know

  • Kidney multi-organ candidate: a patient who is on the wait list needing more than one organ, with one of the organs being a kidney
  • Kidney-alone candidate: a patient who is on the wait list for a kidney and does not need additional organs
  • Multi-organ allocation: offering more than one organ from a deceased donor to the same waitlist candidate

Click here to search the OPTN glossary

Read the full proposal

Provide feedback

eye iconComments

Anonymous | 02/02/2023

Is there a way to "pay back" or add priority to a kidney only recipient that has been passed over multiple times due to multi-organ allocation?

Anonymous | 02/01/2023

I support the proposal, specifically including prioritization of high cPRA kidneys and SLK, Heart Kidney and Lung Kidney.

Steven Weitzen | 01/29/2023

It only makes sense to identify priority shares for purposes of equity.