Diseases of the kidney and urinary tract contribute about 850,000 deaths each year, being the 12th leading cause of death in the world. In Brazil, dialysis is still the most used procedure, although transplantation is the most recommended modality, because it offers a better quality of life for the patient, a possible reduction of mortality risk and lower cost than dialysis. Once in the queue, the patient still faces a set of inefficiencies of the National Transplant System. The present research identifies that one of them is the misalignment between the actors of the transplant (donor, receiver and transplantation unit) and that there is a gap with respect to the activities of the transplantation unit actors. Thus, the objective of this research is to investigate, in the light of operations management, the model of a reference transplantation unit, inserted in the kidney transplant network of the state of Rio de Janeiro. From the literature and field survey, modeling of the renal transplantation process, description and diagnosis of the operation model of the transplantation unit and propositions about the operation project of the studied unit are performed.