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Kidney allocation scheme

NHS Choices Medical Reference

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Kidneys are the most commonly transplanted organ. However, there are many more people who need transplants than there are donors, so the Kidney Allocation Scheme (introduced in April 2006) makes sure that each donated kidney is given to the person who needs it most. The scheme also ensures the best possible match between donor and recipient using criteria such as tissue type, blood group, age and body size. 

Under the scheme, all kidneys from deceased heart-beating donors are allocated according to a national system. This is based on five tiers:

  • tier A: complete matches for hard-to-match child patients (under 18 years old)
  • tier B: complete matches for other children
  • tier C: complete matches for hard-to-match adult patients
  • tier D: complete matches for other adults and well-matched children
  • tier E: all other eligible patients (adults and children)

Within tiers A and B, children are prioritised according to their waiting time.

In the remaining tiers, patients are prioritised using a points system. Organs are allocated to patients with the highest number of points.

The score for an individual patient is based on a number of factors:

  • time on the waiting list (favouring patients who have waited the longest)
  • tissue match and age combined (favouring well-matched transplants for younger patients)
  • age difference between donor and patient (favouring closer age matches)
  • location of patient in relation to the donor (favouring patients who are closer to minimise the transportation time of the kidney)
  • three other factors relating to blood group match and rarity of the patient's tissue type

For more information, see the Organ Donation website or contact them on 0300 123 23 23.

Medical Review: March 28, 2010

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