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Organ sharing in kidney transplantation

William M Bennett, MD
John Vella, MD, FACP, FRCP, FASN
Daniel C Brennan, MD, FACP
Section Editor
Barbara Murphy, MB, BAO, BCh, FRCPI
Deputy Editor
Albert Q Lam, MD


Organ sharing is a nationwide system by which deceased-donor kidneys are allocated to potential recipients. The deceased-donor kidney allocation policy of the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplant Network (OPTN) was extensively revised and implemented December 4, 2014 and is presented in this topic review.

The evaluation of potential transplant recipients, including the optimal timing of referral, and issues related to the transplant waiting list, as well as live kidney paired donation, are discussed elsewhere. (See "Evaluation of the potential renal transplant recipient" and "The kidney transplant waiting list in the United States".)


Overview — A national kidney allocation policy was established in the United States in 1987 for the purpose of the equitable and utilitarian distribution of deceased-donor kidneys.

The policy was initially devised and agreed upon by the transplant programs that comprise the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplant Network (OPTN).

A revised UNOS/OPTN policy was implemented in 2014 in order to increase the utilization of available kidneys, reduce regional variability in access to transplantation, and improve the outcomes for individual kidneys that are transplanted [1].


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Literature review current through: Sep 2016. | This topic last updated: Mar 16, 2016.
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