Perspective on Macroscale Complexity in the National Transplant System

Figure 1

Simplified decision tree of OPOs and transplant hospitals during organ allocation. Allocation begins with the decision to perform procurement of a deceased donor. The term “procurement” in this illustration is abstract and represents the decision to work with hospitals on attempting to allocate the donor’s organs to candidates. OPOs may decide to bypass certain offers, but must document the reason for the exception. Once a transplant hospital is notified, they can either express interest in the offer or decline it outright. Only when no other preceding offers exist does a transplant hospital become the primary responder. Ultimately, the decision to perform procurement and transport donor organs to the accepting facility lies with the OPO.