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Establish Comprehensive Multi-Organ Allocation Policy

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Background

Some organ donors are able to donate several organs: a heart, lungs, liver, intestine, two kidneys, and a pancreas. Some transplant candidates need multiple organs, like a heart-liver transplant, or a liver-kidney transplant. OPTN Policy says when some organs need to be offered together but does not list a standard order for how organs should be offered to candidates who need different organs. This contributes to limited access to transplant for some single-organ candidates and Organ Procurement Organizations (OPOs) report having to spend a lot of time determining how to allocate organs from these donors. There has been wide community support for standardizing multi-organ allocation and promoting equity in access for multi-organ and single-organ transplant candidates.

Supporting Media

Presentation

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Requested feedback

  • The Committee has developed six multi-organ donor allocation tables to establish consistent allocation of multi-organ combinations
  • The six multi-organ donor allocation tables would account for approximately 96% of deceased multi-organ donors, based on data from July 2021-December 2023
  • The Committee requests the community’s input on the proposed multi-organ donor allocation tables and the proposed order of priority

Anticipated impact

  • What it's expected to do
    • Promote equitable access to transplants among multi-organ and single-organ transplant candidates
    • Promote consistent and efficient allocation across all OPOs
  • What it won't do
    • This request for feedback will not change OPTN Policy at this time
      • The committee will use the feedback received to help them finalize a future policy proposal later this year

Terms to know

  • Multi-organ allocation: offering more than one organ from a deceased donor to the same waitlist candidate.
  • Multi-organ donor allocation plan: a system-generated donor-specific plan to guide the user through the applicable multi-organ allocation table.
  • Multi-organ donor allocation table: a table in OPTN Policy directing the order in which OPOs work through match runs and make offers when a donor has more than one organ available for donation.
  • Match Run: a computerized ranking of transplant candidates based upon donor and candidate medical compatibility and criteria defined in OPTN Policy.

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Read the full proposal (PDF)

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