How does the offering system work?

Learn how bowels from deceased donors are offered to patients

Key points

It is important for donated organs to go to patients who will benefit from them
Patients are prioritised based on many different factors
How long you have been waiting for an organ is also taken into account
The organ offer will first go to your transplant team. If they feel it is suitable for you, they will get in touch

How are bowels offered?

Every donated bowel is a precious gift, and it is important that the organ goes to a patient who will benefit from it.

Once a potential deceased donor is identified, blood tests are taken to check the donor's blood group and tissue type and to check the function of their organs. Other blood tests are taken to see whether the donor has any infections.

This information is then passed to NHS Blood and Transplant and a nationally-agreed computer programme checks the national transplant waiting list for suitable patients.

Only patients that are compatible with the donor's blood group, size, and tissue type can be offered the organ. Of those that are compatible, patients are prioritised for the bowel based on:

Blood group
Whether or not other organ transplants are needed at the same time as the bowel transplant
If they have severe liver or bowel disease
How similar the donor and recipient ages are
How long they have been in the waiting list
If they have antibodies in their blood against common tissue types

A national committee agrees the way that deceased donor bowels are offered, with advice from NHS Blood and Transplant. The national committee agrees on how patients should be prioritised and how the computer programme should run.

What happens if you are offered a bowel?

If the bowel is being offered to you, then NHS Blood and Transplant will contact your transplant centre to inform them about the offer. The transplant team at your centre will then examine the donor information and your medical history to decide if the offered organ is suitable for you. Not all organs are suitable for all patients. 

If your transplant centre thinks the bowel offer is suitable for you, you will be contacted by telephone.

In the meantime, surgeons from your transplant team will travel to the donor’s hospital to remove the donor's organs. Donated organs are flushed with a special fluid to help preserve them, then packed in a box with fluid and ice.