How is kidney allocated?

Kidney allocation is decided by unanimous agreement of the Transplant team members and is based on several factors.

When a kidney is donated, the following is considered:

  • In which patient does this kidney have the best chance of success?
  • Which patient needs this kidney the most at the time?

If a donated kidney becomes available, and there is a perfect match (HLA and ABO compatible), the kidney will be allocated to that particular patient. If no patient matches the kidney perfectly, the next best match is considered. If there is more than one patient matching the kidney, it will be allocated based on the following factors:

  • Age (younger patients receive priority)
  • Age difference between donor and recipient (smaller age gap is favored)
  • Time spent on dialysis (patients who have been on dialysis longer will be favored)
  • Time spent on the wait list (patients who have been waiting longer will receive priority)

There is a chance that the kidney might be allocated to two equally matching recipients. At the time of allocation, the potential recipient will be notified if he/she is the primary or secondary candidate for that particular kidney. Both candidates will be asked to come to the hospital for further assessment while the kidney is being harvested/transported. Having the secondary candidate available on site will reduce the time that the kidney has to wait on ice; decreasing damage to it and enhancing the transplant results. If after the final assessments on the primary recipient and kidney show any contraindications for transplant, the secondary recipient will receive the kidney.

This is done in the best interest of the recipients. The transplant team cannot perform a transplant if it is contraindicated in any way for the recipient's health after the final checks.