Organ Procurement Organization and New Kidney Allocation

  • Adam Mathias Frank
  • Ryan Cotto
Living reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Early attempts at kidney transplantation were plagued by technical difficulties; however, as the efficacy of renal transplant increased, so did the demand for the therapy. Organ Procurement Organizations came into being because of the considerable resources required to support deceased donor procurement and ultimate transplantation. On several occasions US legislation has been critical in assisting the build of transplantation infrastructure with the most noticeable piece being the 1984 National Organ Transplant Act which created the Organ Procurement and Transplantation Network (OPTN) as the main body to oversee transplant-related services. With the increasing demand for donor kidneys in the United States, the OPTN continually attempts to optimize the use of recovered organs while still ensuring fair access to transplantation for those on the waitlist. The most recent of these reforms came in December of 2014, with the implementation of the new Kidney Allocation System which brought nine new changes to the rules. The two most important changes are allowing dialysis time to be captured as waiting time for those candidates referred after dialysis initiation and the reliance on the Kidney Donor Profile Index score in directing kidney allocation.


Organ Procurement Organization (OPO) Kidney Allocation System (KAS) Organ Procurement and Transplantation Network (OPTN) National Organ Transplant Act (NOTA) United Network for Organ Sharing (UNOS) Kidney Donor Profile Index (KDPI) Kidney Donor Risk Index (KDRI) Calculated Panel-Reactive Antibody (CPRA) Zero Mismatch Policy 



This work was supported in part by Health Resources and Services Administration contract 231-00-0115. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Thomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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