Current OPTN policy prioritizes candidates seeking a simultaneous liver kidney (SLK) transplant before pediatric and adult transplant candidates who are listed only for a kidney (“kidney alone candidates”) when the liver candidate and the deceased donor are in the same Donation Service Area (DSA). Unlike kidney alone allocation, in SLK allocation, the kidney is not allocated based on medical criteria assessing the kidney function of the candidate. Instead, geographic proximity between the liver-kidney candidate and the donor is the single factor for allocating the kidney with the liver. Organ Procurement Organizations (OPOs) are not required to allocate the kidney with the liver to a regional SLK candidate, although they have the discretion to do so.

The Kidney Transplantation Committee (“the Committee”), has identified several problems with this current policy. This proposal reflects feedback from the 11 OPTN regions, several professional transplant societies, patient advocacy groups, and various OPTN/UNOS committees.

Because there is a tremendous amount of transplant community interest in the development of this policy and a need to ensure a high level of consensus for the final product, the Committee may utilize the Fall 2015 and Spring 2016 public comment periods to receive input on these changes, with an expectation that the OPTN/UNOS Board of Directors will consider final adoption at the June 2016 Board meeting.