Virginia de Bond
Organ Donation & United Network for Organ Sharing (UNOS) Points Systems
There are regional organ procurement organizations (OPOs) who are members of the national Organ Procurement and Transplantation Network (OPTN). Since 1987. OPTN is contracted to the maintenance of the United Network for Organ Sharing (UNOS). All patients who are waiting for an organ from a deceased donor will be placed on a waiting list database. The registrant's number runs more than 81500 currently (Glazier, n.d.). The system matches the organ donated with the OPO service area, with the donors with transplant candidates who are on the waiting list. The patients are matched in the local OPO service area, regionally and nationally. Policies are in place for allocation that considers blood type, medical status (heart and liver), donor weight (nonrenal organs), PRA and HLA tissue type (kidney only), and time spent on the waiting list. Additional points are given to a candidate who has previously donated an organ (kidney), children under 18 years of age and other organ donors (organ-specific rules exists). Candidates who are zero HLA mismatched (kidney) are given priority or points accrued (Glazier, n.d.).
The three important principles accepted by UNOS are: (1) Regional primacy ( right of first usage is given to the procurement area where the organ was obtained, and secondary to anyone in the same UNOS regions- the only exception is when there are a 6 perfect matches elsewhere in the country); (2) Second primary is rejection of a kidney offer by physician judgment that thinks it would be inappropriate; (3) the patient’s right to select transplant center locally or at a distance according to the transplant policy (Starzl, Shapiro, & Teperman, 1989).
Glazier, A. K. (n.d.). Systematic increases in organ donation: The United States experience.
Organ Shortage, 195-212. doi:10.1017/cbo9780511973536.013. Retrieved from https://deepblue.lib.umich.edu/bitstream/handle/2027.42/72348/j.1600-6143.3.s4.4.x.pdf?sequence=1
Starzl, T. E., Shapiro, R., & Teperman, L. (1989, June). The point system for organ distribution.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2983103/