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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

Presentation

View presentation

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.