How does organ donation work and how are organs matched?

Numbers match the citations in the article. A working link isn't proof that a page supports a claim; check the quoted passage and date.

1. 1

   Organ donation (Wikipedia)

   WikipediaPublished Oct 10, 2026Checked Oct 11, 2026

   “Organ donation is defined as the process when a person authorizes an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive, through a legal authorization for deceased donation made prior to death, or for deceased donations through the authorization by the legal next of kin. Donation may be for research or, more commonly, healthy transplantable organs and tissues may be donated to be transplanted into another person. When the donor is still living, this is called a living organ donation; about 6,500 of these occur in the U.S. each year. Common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Some organs and tissues can be donated by living donors, such as a kidney or part of the liver, part of the pancreas, part of the lungs or part of the intestines. In 2019, Spain had the highest donor rate in the world at 46.91 per million people, followed by the US (36.88 per million), Croatia (34.63 per million), Portugal (33.8 per million), and France (33.25 per million).”

2. 2

   Beyond histocompatibility: human leukocyte antigen as a cross-disciplinary platform for immune recognition and clinical decision-making.

   Frontiers in immunology (Mandal et al.)Published Sep 8, 2026Checked Oct 11, 2026

   “Pharmacogenomic testing has clearer clinical value for selected drugs, including abacavir, carbamazepine and allopurinol. In cancer, loss of classical HLA expression and non-classical HLA-E and HLA-G pathways contribute to immune escape and are being explored as therapeutic targets. In transplantation, HLA assessment increasingly combines donor-specific antibodies, crossmatch results, molecular mismatch and organ-specific risk. Eplet, amino-acid and predicted indirect T-cell epitope mismatch can support risk assessment at population level, but no single score should determine organ allocation or immunosuppression. HSCT differs because the graft transfers a donor immune system, creating competing risks of graft failure, graft-versus-host disease and relapse. Clinical implementation requires reliable assays, validated clinical associations, evidence of patient benefit, multi-ancestry validation, consistent reporting and equitable access. We distinguish established clinical practice from developing risk-stratification methods and early mechanistic findings.”

3. 3

   Development and clinical implementation of a local automated kidney allocation platform integrating virtual crossmatch.

   Frontiers in immunology (Awaji et al.)Published Aug 27, 2026Checked Oct 11, 2026

   “We conducted a single-center implementation study consisting of a cross-sectional analysis of 219 active kidney transplant candidates and a retrospective comparison of 67 deceased donor match runs processed by the automated KAS and the historical manual VXM workflow. The primary outcome was identification of potentially compatible highly sensitized patient (HSP) events. Analyse.ResultsOf 219 candidates, 98 (44.7%) were highly sensitized (cPRA ≥80%). Elevated prevalence of HSP was associated with prior transplantation, pregnancy, and transfusion. HSP candidates waited far longer than non-sensitized peers (median 7.10 vs. 3.81 years; p ConclusionsA locally developed automated KAS substantially improved compatible donor identification for highly sensitized kidney transplant candidates while reducing VXM turnaround from hours to minutes. By enabling comprehensive evaluation of every eligible candidate during each deceased donor workup, automated allocation represents a practical and potentially scalable strategy that could improve equity and operational efficiency.”

4. 4

   Transplantation (medicine) (Wikipedia)

   WikipediaPublished Oct 7, 2026Checked Oct 11, 2026

   “Transplantation is a medical procedure in which an organ, tissue, or cells are removed from one organism and placed in a recipient organism, often to replace a damaged or missing function. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source. Organs that have been successfully transplanted include the heart, kidneys, liver, lungs, pancreas, intestine, thymus and uterus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), corneae, skin, heart valves, nerves and veins. Worldwide, kidneys remain the most commonly transplanted organs, followed by liver and heart. Global analyses indicate that available transplants meet a minority of worldwide need, with the Transplant Observatory reporting substantial gaps between demand and supply and year-to-year increases in registered transplant activity in recent data releases. J.”

5. 5

   System-level Barriers Reducing Access to Transplantation: Results of a Global Survey.

   Transplantation direct (Herrera-Gayol et al.)Published Sep 25, 2026Checked Oct 11, 2026

   “Respondents were grouped according to the mean deceased donation (DD) rate per million population from years 2016 to 2019 and 2021: Group (G) 1 (G1) No DD reported, or no data provided to global observatory on donation and transplantation; (G2) ResultsWe present answers from program directors. There were 150 program directors from 438 respondents. Financial barriers ranked highest, negatively affecting access to transplantation worldwide. G1 indicated the highest percentage of challenges. Those from G4 and G5 provided the least amount of challenges; however, training programs remain areas for improvement. Responses from G2 and G3 were similar, positioned between those from G1, and G4 and G5.ConclusionsThe organ shortage emergency is exacerbated by parallel system-level deficiencies. This global survey identifies specific, actionable deficits that must be addressed to build equitable transplant systems worldwide.”

6. 6

   Transforming organ donation and transplantation: challenges, innovations, and future directions.

   Frontiers in transplantation (Patil & Patil)Published Aug 5, 2026Checked Oct 11, 2026

   “The paper also outlines the major challenges in the current systems and the new technologies that will be able to revolutionize the transplantation processes such as Artificial Intelligence, Blockchain, Internet of Medical Things (IoMT) and Big Data Analytics. At the same time, new technologies that would help to extend the "liveness" of organs are also carefully analysed as potential ways to simplify the choices, improve the transparency and logistics. While there are solutions to these technologies, some barriers to the technologies are interoperability, governance, ethical issues and the availability of infrastructure. Lastly, the paper provides the research directions in the future, which revolve around convergence of heterogeneous technologies, development of interoperable data ecosystems and the necessity of having equitable and patient-centered transplantation systems. Overall, this review provides an in-depth opinion of the problems, innovations, and directions that need to be introduced to transform organ donation and transplantation into a more efficient, transparent, and accessible healthcare sector on the international scale.”