What is Your Number on the Kidney Transplant Waiting List, and How is it Determined?

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Given that  the average wait time for a kidney transplant can vary from two to ten years, depending on several different factors, how does an offer from the waiting list really work? When a donor kidney becomes available, the transplant coordinator will call you and discuss specifics about the kidney. They will discuss with you any issues or concerns regarding it and will let you know if this  kidney is best for you.  You will always have the right to decline a donor kidney.  However before you get to make that choice, there are many steps to determine if you are the best candidate for the kidney.

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A total of approximately 93,000 patients are registered on the kidney transplant waiting list at the United Network for Organ Sharing (UNOS) in the United States. The list has been expanding by 3000 to 4000 patients each year but the steady increase in the number of active candidates (eligible for  transplants) has consistently been only 50,000 people. When transplant hospitals accept patients onto the waiting list, the patients are registered in a centralized, national computer network that links all donors and transplant candidates coordinated by UNOS and the Organ Procurement and Transplantation Network (OPTN). The UNOS Organ Center is staffed 24 hours a day throughout the year, and it assists with the matching, sharing and transportation of organs via this computer network.

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You do not hold a specific spot on the National Transplant Waiting List. Rather, your information is kept in the computer network and as a kidney becomes available a computer program generates a list of potential recipients ranked according to objective criteria including: blood type, tissue type, size of the organ, your medical urgency, time on the waiting list, and distance between donor and recipient. Each donor kidney has its own specific criteria. For instance, time and difficulty on dialysis is taken into consideration when matching a kidney from a donor that is older than 60. Ethnicity, gender, religion, and financial status are never taken into account in the computer matching system.

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After the match is made, the procurement coordinator will contact your transplant surgeon. Depending on various factors, such as your medical history and current health, the transplant surgeon determines if the kidney is suitable for the patient. If it is turned down by your surgeon, the next listed individual's transplant center is contacted. When a patient is selected, he or she must be available, healthy enough to undergo major surgery, and willing to be transplanted immediately. However, should you decline that kidney, you will not be automatically offered the next available kidney but you will have to wait until another compatible one becomes available.

Recommended Reading: Donor Kidneys Represent 1% of All Deaths: Should We Be Able to Snatch Life from the Jaws of Death?

Carefully consider all of the issues before you decline or accept a kidney offer. While you are on the wait-list it is critical that you make sure that the coordinators have all of your current contact information, especially if you change phone numbers, address, dialysis schedule/location, insurance, etc. If they cannot reach you, or your insurance has not been updated, you could lose out on an offer and be denied a possible transplant. If you have an infection or a cold you may not be able to receive the kidney so it is important to stay as healthy as possible.

Recommended Reading: Donor Kidneys Represent 1% of All Deaths: Should We Be Able to Snatch Life from the Jaws of Death?

KidneyBuzz.com recommends that you discuss with your transplant coordinator the average wait times for your transplant region. Work with your healthcare team to discuss means to accelerate your wait time such as Multi-Listing, Donor Exchange Programs, and Non-Directed Donor Chains.

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"How the Transplant System Works: Matching Donors and Recipients." United Network of Organ Sharing

"How the Transplant Waiting List Works." Renal Support Network

"The Kidney Transplant Waiting List." Up To Date.
"Donation and Transplantation." OPTN: Organ Procurement and Transplantation Network

"Kidney Transplant Allocation Policy." Renal Fellow Network: Kidney Transplant Allocation Policy.