DLM: April 4 - Question of the Day
Throughout the month of April, we will be answering all questions around organ donation & transplants. The goal is to spread knowledge & facts while inspiring others to have conversations and register as organ & tissue donors.
In order to understand the matching & waiting process, let me first introduce you to the United Network for Organ Sharing (UNOS). It is a common misconception that UNOS is a government agency however, UNOS is a private, non-profit organization that is contracted by the Department of Health & Human Services to manage the organ transplant system.
UNOS is responsible for matching donors & recipients 24 hours a day, 365 days a year. Matching is done by a technology system based on algorithms approved by UNOS' Board of Directors.
Now that we know about the organization that manages matching, let's look into some of the factors that go into matching the candidate and the donor. Please note that these are guidelines and highlights only. There are detailed policies & procedures that determine matching criteria for every type of organ. You can review the Factors in Organ Allocation on the UNOS webpage.
Only medical and logistical factors are used in organ matching.
Personal or social characteristics such as celebrity status, income or insurance coverage play no role in transplant priority.
When an organ becomes available, the UNOS system first reviews medical factors of candidates that would potentially make them incompatible with a donor graft. These medical factors are things such as blood type, height & weight.
The system then looks at geography. Organ transplants are most successful when preservation and transport time are short. The matching system considers the distance between donor and transplant hospitals. In general, local candidates get organ offers before those listed at more distant hospitals.
The size of the organ. Proper organ size is critical to a successful transplant, which means that children often respond better to child-sized organs. Although pediatric candidates have their own unique scoring system, children essentially are first in line for other children’s organs. **A new policy ensuring children liver candidates are prioritized over adult candidates when the donor organ is from another child will be implemented April 30, 2019**
When a transplant hospital accepts a person as a transplant candidate (aka when someone is "officially listed" at a transplant hospital), the hospital enters medical data into the UNOS computerized network. This data includes medical information like the candidate's blood type, medical urgency, the location of the transplant hospital, etc...
When an organ procurement organization gets consent for an organ donor, it also enters medical data into the UNOS computer system. Information about the donor includes (but is not limited to) the donor’s blood type, body size and the location of the donor hospital.
Using the combination of donor and candidate information, the UNOS computer system generates a “match run,” a rank-order list of candidates to be offered each organ. This match is unique to each donor and each organ. The candidates who will appear highest in the ranking are those who are in most urgent need of the transplant, and/or those most likely to have the best chance of survival if transplanted (some of the factors that go into matching)
Think of organ matching being similar to online dating. Both parties (the candidate & the donor) enter relevant information into a centralized computer system (or app) and the system lists/matches the profiles that are most compatible.
How long does someone have to wait once listed?
This is an incredibly complicated answer and it's incredibly frustrating that I cannot list wait times here. If anything, you now understand some of the details and complexities that go into finding a match for each candidate waiting for a life-saving organ.
However, I will leave you with the official UNOS answer:
"Once you are added to the national organ transplant waiting list, you may receive an organ that day, or you may wait many years. Factors affecting how long you wait include how well you match with the donor, how sick you are, and how many donors are available in your local area compared to the number of patients waiting."
Register to be a donor?
Click on the "Become a Donor" tab on the homepage
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