Getting a transplant means you get medicine that supress your immune system so as to not reject the freshly transplanted organ. You have to take that immunosupressing medicine for between 6 month to a year. With immunosupressant geting covid unvaccinated is basically a death sentence. Organs on the other hand are in very limited supplies so yeah doctors have to prioritise those who have the greatest chances of survival. That's basic math.

There's no waiting list of other patients who might need it though. It's a direct donation. If this person gets covid and dies while on immuno suppressants then it's just on them and nobody else is effected. So why not go for it?