Factors in the Donation Process

After a person dies, a complex and highly choreographed process goes into action to make donated organs available to a patient on the waiting list. But before the transplant can take place, a number of things happen.

  1. Information about the organ (size, condition, blood and tissue type) is gathered by the Organ Procurement Organization (OPO) and sent to the United Network for Organ Sharing (UNOS). UNOS is the organization designated by the federal government to oversee all transplants done within the United States. It is responsible for maintaining the patient waiting list and assuring all patients waiting for an organ transplant have equal and fair access to available organs.
  2. Based on waiting time, blood and tissue match and other key factors, a patient on the UNOS list who is most qualified for an available organ is selected and his or her transplant center is notified.
  3. Even though the patient seems like a good match and all criteria for the organ are met, the transplant center must still accept the organ. Several factors need to be considered by the transplant team in a very short period of time before accepting the organ for that patient. In some cases, if the team thinks the organ might pose a risk to the potential recipient, the organ is refused. Reasons an organ may be refused include:
  • Patient condition – The transplant surgery might be too much for the patient in their current condition.  (Too sick for surgery.) Or, the patient might be out of town or otherwise unavailable for transplant at the time.
  • Donor condition – Some illness - such as high blood pressure or diabetes - might have caused harm to the donated organ.
  • Organ condition – The organ might have been outside the body for too long, damaged during recovery or damaged during transport to the transplant center. In some cases, organs are refused upon final examination when issues like too much fatty tissue or poorly formed blood vessels are noticed.
  • Donor/recipient compatibility – Important matching tests done just before surgery in some cases uncover unknown incompatibilities that would result in failure of the transplant.
  • Transplant center factors – The organ cannot be transported to the center within an acceptable time frame.



Number of kidney transplants performed in the United States. Learn More