If the woman whose kidney transplant was botched recently at the University of Toledo Medical Center has to be placed on the national kidney waiting list, she won't get any special consideration because of her tragic situation.

The United Network for Organ Sharing, the nonprofit group that oversees the allocation of the nation's donated organs, said on Thursday that the waiting list is designed to give out kidneys based on a points system that is scored by a computer-directed, complex algorithm of factors that does not include giving extra points for aborted surgeries.

Those factors include the donor and recipient's health, age, weight, whether their antigens and blood type match, how long a recipient has been on the wait list, and even where both are located geographically, because by federal policy, organs are to be offered first to matching patients closest to where they are harvested.

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Having a transplant canceled because a nurse threw the donated kidney away is unfortunate, but "it would not affect" the woman's ranking on the waiting list, said Anne Paschke, a UNOS spokesman. "The only people who get additional points because of a surgery are living donors, if they need a transplant sometime in the future."

Earlier this summer, a hospital in New York tried to intercede and get a man moved up on the kidney waiting list because it had accidentally killed his living donor, who was his sister, claiming that it was a "compassionate organ donation."

But the Organ Procurement Transplant Network, the federal agency run under contract by UNOS, stepped in and told the hospital that organ allocation only can be made "based upon established medical criteria" and not on "compassionate grounds."

That's the only way it should be, say experts who deal with the waiting list.

With more than 114,000 people on the organ waiting list -- 92,000 of them waiting for kidneys -- at the nation's 250 transplant centers and not nearly enough organs to meet demand, 18 people die every day waiting for a transplant. In Ohio alone there are 3,416 people on the waiting list, with 2,688 waiting for kidneys, according to OPTN.

"No matter how you work the waiting list, you're going to have winners and losers," said Robert Gaston, medical director of the kidney transplant program at the University of Alabama at Birmingham Hospital and the immediate past president of the American Transplant Association.

The waiting list is effective, he said, but "the issue is: Could it work more effectively?"

Transplant experts continue to attempt to tweak the allocation policies and computer programs to ensure that the most needy and compatible patients get the organs they need, though those alterations cause uproars.

This year, UNOS began enforcing a policy that gave preference to pediatric patients over older patients in allocating kidneys. The policy change was aimed at making the most efficient use of a limited supply, it was argued, but the decision raised howls of age discrimination nonetheless.

With all the factors that go into matching a deceased donor with a living patient, calling it a waiting "list" isn't the best way to describe it, Ms. Paschke said.

"It's more a pool of patients who go up and down the list every time a new organ is received, based on how compatible they are," she said.

A recipient might be much higher on the list for an organ from one donor, and lower for another. And each organ has different factors that are weighted differently, based in part on how fragile the organ is, and what the options are for a person to stay healthy and alive without it.

So, for example, the health of the recipient is a more important factor for people on the heart, liver, and lung waiting lists than for kidneys, because people with heart, liver, or lung disease do not have the option of going on dialysis like kidney patients do.

But if the woman in Toledo had other siblings who might consider donating a kidney to her, or even a friend, even if they weren't a so-called "perfect match," any of them would be a better match for her than a kidney taken from a deceased person, said Kenneth Andreoni, associate professor of surgery at the University of Florida and the vice president of the UNOS board of directors.

The Block News Alliance consists of The Blade and the Pittsburgh Post-Gazette. Sean D. Hamill is a reporter for the Post-Gazette.

Contact Sean D. Hamill at: shamill@post-gazette.com or 412-263-2579.

First Published August 24, 2012, 5:19 a.m.