Under the National Organ Transplant Act, organ transplantation
in the United States is overseen by the U.S. Department of
Health and Human Services (DHHS). Specifically, the Division
of Transplantation (DoT), which is part of the Health Resources
and Services Administration (HRSA), is in charge of a federal
contract that established and maintains the national waiting list and
distributes cadaveric organs fairly. This organization is called the
OPTN (Organ Procurement and Transplantation Network) and
the contract is currently held by the United Network for Organ
Sharing (UNOS).

Organs are allocated (given) according to strict rules that take
into account physical matching, tissue and blood type matching,
medical criteria, waiting time, severity of illness, etc. The
allocation system is blind to name, race, sex, and wealth.

The allocation rules have been developed over many years of
deliberation by physicians and other transplant professionals,
transplant candidates and recipients, donor families, and
representatives of the federal government. You can see the
policies in their entirety at
http://www.unos.org/About/policy_policies.htm.
They are periodically adjusted, as medical knowledge grows and
the field of transplantation changes in the U.S. Any proposed
changes are open to public comment. The latest new ideas that
are out for public comment can be viewed online
(http://www.unos.org/About/publiccomment/
policy_public_comment.htm).