Wait List Management

Abstract

Transplant candidates waiting for a kidney transplant from a deceased donor are registered on a national transplant waiting list, maintained by the United Network for Organ Sharing (UNOS). UNOS matches deceased donor kidneys to recipients, taking into account both efficiency (graft and patient survival) and equity (fair distribution). Organ allocation is a complex system, taking into account blood type, HLA matching, degree of sensitization, pediatric recipients, and time waiting on the list. Listing practices take into account median wait times and allocation variances within the region, as well as list size, while optimizing resource utilization. There is a great disparity in the number of candidates awaiting kidney transplants compared to the number transplanted each year. UNOS is involved in a comprehensive review of the kidney allocation process, working toward improving the current system. The new allocation system would strive to maintain access for all candidates, while trying to maximize outcomes from each kidney.