How Are Organs Made Available?
United Network for Organ Sharing (UNOS)
The Transplant Center at Virginia Mason, like all transplant centers in the United States, is part of a national linked organ-sharing network. This network is called United Network for Organ Sharing (UNOS). UNOS is a non-profit organization that has a regulated system to assure equal access for all patients needing a transplant. All transplant patients at Virginia Mason are registered with UNOS. UNOS maintains a centralized computer network linking agencies and transplant centers across the country. This network is available 24 hours a day. UNOS provides a toll-free patient service line to help transplant candidates, recipients and family members understand organ allocation practices and transplantation data. The toll-free patient service line number is (888) 894-6361.
LifeCenter Northwest (LCNW)
Each region of the United States works with one or more Organ Procurement Organizations (OPOs). LifeCenter Northwest is the OPO for Alaska, Montana and Washington. LCNW works with hospitals to identify possible donors and to make these kidneys available to transplant centers. The LCNW staff are notified by a regional hospital of a potential organ donor and quickly contact a transplant center, like Virginia Mason, and the family. Specific medical information and tests are used to assure that the organs will be safe to use. If there is willing agreement about donation, screening tests are completed between the donor and the top potential recipients on the list, including ABO blood type and HLA tissue typing.
LCNW enters the results of these tests into the UNOS computerized network. Possible recipients listed with UNOS are grouped into a "pool" of names. This "pool" of potential recipients is generated and ranked according to published UNOS policies1 . After making sure all patients in the "pool" are ready, they are further tested with this donor. The order of ranking is based on points assigned to specific factors including length of waiting time, closeness of the match, and how "sensitized" the recipient may be. A close match with the donor, longer waiting time on the list, and those with higher antibody levels are assigned more points. Finally, individuals with the highest point totals will be contacted and instructed to come to the hospital for a transplant. This process has several steps where our transplant nurse coordinator contacts the patient's doctor, the Virginia Mason nephrologist and the transplant surgeon. All team members discuss the case ahead of time.
The person person with the highest points is called the "primary" recipient, and there may be several "backup" recipients in case tests show the primary recipient may not tolerate a kidney from this donor.
1. The resource for current data is www.unos.org and check links for OPTN data. Much other important information is at this site.