Identify Priority Shares in Kidney Multi-Organ Allocation

At 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

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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

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Read the full proposal