to put in place an organ procurement and transplant network. This network was to develop a national policy to assure equitable organ allocation. A point system developed through the University of Pittsburgh and later published in the New England Journal of Medicine was offered to UNOS by Dr. Thomas Starzl to be used nationally for allocating kidneys, livers, and thoracic organs. The UNOS Board of Directors adopted Dr. Starzl's point system in May 1987 and implemented it on October 1, 1987, the date that the Organ Procurement and Transplant Network (OPTN) became operational.

In June 1988, the Board of Directors approved an allocation system for hearts and heart-lung combinations. This new system was not based on points, but instead allocated organs first locally, then to recipients within a 500-mile radius of the donor hospital, followed by recipients within a 500-1,000 mile concentric circle, and then finally, to all recipients beyond a 100-mile radius. These organs were allocated first to Status I patients (those patients who were critically ill and in urgent need of a transplant), and secondly, to Status II patients (all other potential heart recipients). (See UNOS Policy 3.7.) That policy went into effect January 4, 1989. At the February 1989 Board Meeting, the Board of Directors approved a modification of the point system for renal allocation that put a higher emphasis on antigen matching while maintaining a major emphasis on the length of time potential recipients had been waiting. Additionally, the new match process only considered the percent reactive antibodies of the recipient if the level exceeded 80 percent reactive antibodies and a preliminary negative crossmatch was available (see Policy 3.5). A simple pancreas allocation policy was developed in 1989 (Policy 3.6.10). Also in 1989, a slight modification was made to the liver allocation policy found in section 3.6 of the policies. The current organ allocation policy for each organ follows this chapter.

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