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How is the Organ Placed

Generating a List

UNOS maintains a list of people who are potential transplant candidates and this can be accessed by the NEOB. The Transplant Center sends UNOS the patients' medical information for placement on this list. NEOB is involved with making sure the organs are allocated to the correct patient.

The list has each person's medical and biological information that are necessary for matching with potential donors - details that are important for kidney allocation. Blood type is key. A crossmatch test is performed for listed patients with blood types that are compatible with the deceased donor. The organ bank laboratory combines white cells from the donor with serum from different possible kidney recipients. The crossmatch has to be negative for UNOS and NEOB to offer the organ to a transplant center for a specific recipient.

In addition to this test, UNOS uses a point system for people who are waiting for a kidney transplant. UNOS gives points for the following criteria:

  • The number of similar antigens (proteins important for transplant rejection) between donor and recipient.
  • Time spent on the waiting list.
  • The distance between the hospital where the donor is (in Massachusetts, Rhode Island, Connecticut, New Hampshire or Maine) compared to the recipient's transplant center.

If you are waiting for a simultaneous kidney and pancreas, UNOS and NEOB allocate the organs according to the kidney criteria.

Getting a kidney from the list is NOT based on financial or celebrity status, religion, sexual orientation or gender.

One Hour to Accept or Decline

If UNOS determines that you meet all criteria, our transplant team gets an offer for that kidney to be given to you. The BIDMC transplant team accepts or refuses the kidney for you based on:

  • Established medical criteria
  • The condition of the organ
  • Risk factors for a poor transplant result or disease transmission
  • Your current medical status

Our transplant team has only one hour to accept or refuse an organ. This includes the time it takes us to locate you. We may need to decline the kidney if you cannot be reached in 60 minutes. If we decline the kidney, then the NEOB offers it to the next potential recipient on the list. Please make sure we are always able to reach you.

Allocating deceased donor organs is a complex process. If you have any questions, please ask your transplant team.

Contact Information

Transplant Institute
Beth Israel Deaconess Medical Center
Lowry Medical Office Building, 7th Floor
110 Francis Street
Boston, MA 02215
617-632-9700