Expedited placement to maximize utilization of marginal organs

Emmanouil Giorgakis, Amit K. Mathur

Research output: Contribution to journalReview articlepeer-review


Purpose of reviewDeceased donation represents the largest supply of organs for transplant in the United States. Organs with suboptimal characteristics related to donor disease or recovery-related issues are increasingly discarded at the time of recovery, prompting late allocation to candidates later in the match sequence. Late allocation contributes to organ injury by prolonging cold ischemia, which may further lead to the risk of organ discard, despite the potential to provide benefit to certain transplant candidates.Recent findingsExpedited placement of marginal organs has emerged as a strategy to address the growing problem of organ discard of marginal organs that have been declined late after recovery. In this review, we describe the basis for expedited organ placement, and approaches to facilitating placement of these grafts, drawing examples from kidney and liver donation and transplantation globally.SummaryThere is significant global variation in practice related to late allocation. Multiple policy mechanisms exist to facilitate expedited placement, including simultaneous offers to multiple centers, predesignation of aggressive centers, and increasing organ procurement organization autonomy in late allocation. Optimizing late allocation of deceased donor organs holds significant promise to increase the number of transplants.

Original languageEnglish (US)
Pages (from-to)640-646
Number of pages7
JournalCurrent opinion in organ transplantation
Issue number6
StatePublished - Dec 1 2020


  • cold ischemia time
  • expedited organ placement
  • kidney transplant
  • late allocation
  • liver transplant
  • organ procurement

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy


Dive into the research topics of 'Expedited placement to maximize utilization of marginal organs'. Together they form a unique fingerprint.

Cite this