Two men have died after worm-infected kidneys were transplanted from an alcoholic donor.
The case has raised questions about the checks in place during transplantation and why other hospitals seemingly rejected the organs.
So how are organs chosen for transplant?
More than 19 million people are on the UK's organ donor register, but only a small number will eventually become organ donors.
People have to die in the correct circumstances to ensure the organ is preserved for donation to be even considered.
If donation is a possibility then two questions dominate: "Can the organs be used safely in anybody?" and "Who are they allocated to?"
First there is an assessment of the quality of the organs. Transplant teams use their medical experience to decide whether an organ is functioning well at the time of death or if it is likely to improve after transplantation.
Being an alcoholic does not mean an organ fails this test. However, it is more likely to prevent a liver being donated than other organs such as the kidney.
Meanwhile a team of 250 specialist nurses based at hospitals across the UK assess the suitability of the donor.
It involves contacting the potential donor's GP for their medical history, filling in any blanks with the family and performing blood tests for infections such as hepatitis and HIV.
They also record the donor's tissue type and blood group
According to the NHS, there are only three scenarios in which organ donation is completely ruled out:
- a cancer that has spread in the past year
- a severe or untreated infection
- the human form of "mad cow disease" - Creutzfeldt-Jakob disease
However, the available information can be scant. Healthy people may never visit a GP and then die suddenly, while others may hide personal details from their family.
Who gets it?
If any organs are suitable for donation, they are made available through the NHS Blood and Transplant Electronic Offering System.
The exact details depend on the type of organ.
Kidneys are allocated to individual patients on the waiting list using a complex computer algorithm.
Others such as livers are offered to transplant centres rather than being designated for a specific patient.
It is then up to the transplant team to assess the risks and benefits of an offered organ for their patient.
An organ that would be rejected for one patient may be suitable for another.
The odds of heart problems rapidly increase for dialysis patients over the age of 50. Doctors with an older patient on their books would be more likely to accept a marginal organ that could have been rejected by other teams.
When the organ comes from a patient with encephalitis/meningitis, as the worm-infected kidneys did, then this is a major alarm bell for doctors as it is a sign of an undetected infection.
It shifts the balance of risk and benefit - but it does not rule out a transplant.
In the 10 years to March 2013, there have been 159 transplants from 52 such donors. Ninety-four of those transplants were kidneys.
If a transplant centre decides against using the offered organ then it is offered to the next on the computer-generated list.
After three rejections a "fast-track offer" kicks in and the organ is made available to all 25 transplant centres in the UK.
The units that express interest are then ranked by patient need and the destination is chosen.
Prof Derek Manas, vice-president of the the British Transplantation Society and a surgeon at the Freeman Hospital in Newcastle, said it came down to assessing risk.
"Some surgeons are very risk-averse as they only want the best organs and guaranteed outcome, while others take a risk for a specific patient if the chance of survival is otherwise short.
"We are the most regulated and monitored country, we are audited all the time. It's not like we're not allowed to do maverick things."
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