How the Transplant List Works
Matching Donors and Recipients Under contract with the U.S. Department
of Health and Human Services' Health Services & Resources Administration
(HRSA), the United Network for Organ Sharing (UNOS) maintains a centralized
computer network linking all organ procurement organizations and transplant
centers. This computer network is accessible 24 hours a day, seven days a
week, with organ placement specialists in the UNOS Organ Center always
available to answer questions.

After being referred by a doctor, a transplant center evaluates the possible
transplant. The transplant center runs a number of tests and considers the
patient's mental and physical health, as well as his or her social support
system. If the center determines that the patient is a transplant candidate,
they will add the patient's medical profile to the national patient waiting
list for organ transplant. The patient is not placed on a ranked list at
that time. Rather, the patient's name is added to the "pool" of patients
waiting.

When a deceased organ donor is identified, a transplant coordinator from an
organ procurement organization (here, that's us - Southwest Transplant
Alliance) accesses the UNOS computer. Each patient in the "pool" is matched
by the computer against the donor characteristics. The computer then
generates a ranked list of patients for each organ that is procured from
that donor in ranked order according to organ allocation policies. Factors
affecting ranking may include tissue match, blood type, length of time on
the waiting list, immune status and the distance between the potential
recipient and the donor. For most organs, the potential recipient's degree
of medical urgency is also considered. Therefore, the computer generates
a differently ranked list of patients for each donor organ matched.

The organ is offered to the transplant team of the first person on the list.
Often, the top patient will not get the organ for one of several reasons.
When a patient is selected, he or she must be available, healthy enough to
undergo major surgery, and willing to be transplanted immediately. Also, a
laboratory test to measure compatibility between the donor and recipient may
be necessary. For example, patients with high antibody levels often prove
incompatible to the donor organ and cannot receive the organ because the
patient's immune system would reject it.

Once a patient is selected and contacted and all testing is complete,
surgery is scheduled and the transplant takes place.