When a patient does not have a family member or loved one willing to donate, and there is no other living donor available, then there is no other option but a transplant from a deceased donor. The patient is put on the waiting list with other renal (kidney) patients that is kept by UNOS, the United Network for Organ Sharing. This national organization is charged with fairly setting a priority for organs as they become available across the country.

Priority is based on several factors, including length of time waiting on the list, ABO blood type and degree of HLA matching. Deceased donor kidneys come from people who have died suddenly, usually from an accident or bleed into the brain.

Deceased kidney donors are usually between the ages of one and 70 years. They have been relatively healthy before their death. These people have previously expressed to their families a willingness to donate their organs or their families have made the decision to donate their organs so that someone else will have a chance to live a better life. It is unnecessary to match the donor and recipient for age, sex or race. All donors are screened for hepatitis viruses and the AIDS virus. However, non-living donor organs are tested extensively to insure that they do not pose a health threat to the recipient. Also, many studies, such as ABO blood type and HLA matching, are performed to insure that their organs function appropriately.

As soon as the deceased donor is declared legally brain-dead, the kidneys are removed and placed in sterile fluid similar to the fluid in body cells. They are then stored in the refrigerator. It is customary to transplant all kidneys within 24 hours of recovery. This is the reason that many patients are called to come to the hospital in the middle of the night.