ABSTRACT
The largest mismatch is in renal transplant where wait times can be in excess of 5 years, depending on blood type and region. Of all the organs listed, intestinal transplant has the worst patient survival. Contraindications based on donor and recipient characteristics differ for each organ and are continually re-examined and revised. For most centres recipient active infection is an absolute contraindication. Organ allocation follows detailed and complex algorithms that include severity of recipient disease and proximity of donor to recipient. In the United States liver allocation is based on the paediatric end-stage liver disease score, which is calculated with a formula based on serum bilirubin, international normalised ration and serum creatinine. Organs are principally allocated based on proximity and waiting time. Extra points are given for human leukocyte antigen matching and priority for younger donors is given to paediatric recipients. There is an ever-increasing mismatch between numbers of patients awaiting transplant and availability of deceased organ donors.
