Transplantation can best be thought of as a journey. The steps leading to your transplant are as follows:

• Your doctor recommends that you be evaluated for transplant
• You are evaluated for a transplant by the medical team at a transplant hospital
• Once you have been qualified, the transplant hospital registers you on the UNOS waiting list
• Map out your financial strategy
• The waiting period
• The transplant
• Post-transplant events

The Transplant Waiting List
All patients accepted onto a transplant program’s waiting list are registered with UNOS. UNOS maintains a centralized computer network linking all organ procurement organizations and transplant centers. Organ placement specialists operate the network 24 hours per day, seven days a week.

The Matching Process
When an organ becomes available, the local procurement organization coordinates the surgical recovery team, accesses the UNOS computer, enters information about the donor organs and runs the match program. This computer program generates a list of patients ranked according to objective medical criteria such as blood type, tissue type, size of the organ and medical urgency of the patient. Other factors are time spent on the waiting list and distance between the donor and the transplant center. The specific criteria differ for each type of organ.

The list of patients waiting in the local area is checked first (except for kidneys, which are sent to perfectly matched patients, no matter where in the country the patient lives). If no match is made with the patients listed locally, the organ is checked against the regional list of patients waiting. If no match is made on the regional list, the organ is made available to patients nationwide.

The computerized matching process can locate best possible matches between donor organs and the patients who need them, but the final decision rests with the patient’s transplant team.

The Organ Offer
When an organ is offered, the transplant team must consider several factors to decide the best medical care for their individual patient.

It is not unusual for a transplant team to say "no" to a particular organ. This is a normal part of the matching process. After being turned down for one patient, the organ is offered to the next patient on the list. These offers continue until the organ is placed.

How Policies Are Made
The organ distribution and matching process is based on policies developed by UNOS members. As the science of transplantation continues to advance, UNOS policies also evolve. The goal of UNOS policy-making is to create a system that gives every transplant candidate a fair chance at receiving the organ they need.


SOURCE:  UNOS  Copyright © 1998, United Network for Organ Sharing