What Is the Transplant Waiting List?

The national transplant waiting list is a database of all the people in the United States who are registered to receive an organ when one becomes available from a deceased donor. The United Network for Organ Sharing (UNOS) manages this list. Another name is added to the national transplant waiting list every 9 minutes. Currently, more than 100,000 people need a lifesaving organ transplant.

Once on this list, you may receive an organ quickly or wait many years to get one. Most transplant candidates wait for quite some time as there are not enough donor organs for everyone in need. Wait time is also affected by which life-saving organ is needed. Those waiting for a kidney generally wait an average of 3 to 5 years, while those waiting for a heart or lung might be matched in less than a year.

Organ allocation is not ranked by number, but rather computer-generated. Complex criteria are based upon location, medical urgency, survival benefit, and genetic compatibility of the recipient. Local patients receive preference, when possible, as the less time that elapses for organ transport, the greater chance of success. But those most in need are placed on an active waitlist and often given priority over others. Pediatric patients or prior living donors may be granted special consideration.

How do I get on the waiting list?

Once your healthcare specialist determines that you are, or may soon be, in organ failure, you will be referred to a transplant center in your area. Once there, a transplant physician will evaluate whether you qualify for organ transplantation.

There are several requirements you must meet to be placed on the national transplant waiting list. These may slightly differ depending on the organ you need, but generally, all cover some key elements. A medical team will first help to determine whether a living donor is an available option to you. You may still be placed on the waiting list even if there is a potential for one. A comprehensive physical examination, diagnostic testing, and lab studies will determine how well your organs are functioning and whether your decline warrants the need for transplantation. If not, you will be monitored and returned to the center for future testing when warranted. 

If you are still considered a potential candidate, further testing will evaluate your ability to tolerate surgery. Any signs of other life-threatening conditions like heart disease, diabetes, infections, or cancer could disqualify you. Genetic testing will also be performed, so you can be matched with a donor organ. You will meet with financial counselors to ensure that you can afford the surgery, as well as the mandatory anti-rejection medications following transplant.

A full psychological evaluation will also be conducted to rule out any mental health issues that might interfere with your ability to adjust to life post-transplantation. Lastly, the medical team will monitor whether you are following a current medical regimen to maintain the best health possible while you wait for a donor organ. Any non-compliance, like drinking alcohol while treating liver disease or substance abuse disqualifies any potential candidate.

What happens after I get on the list?

Your transplant center will not notify you when you have been added to the national transplant waiting list. If you have any questions, you should reach out to your medical team at that center. You may have the ability to register with more than one center in your area to increase your chance of receiving an organ as a multiple listing. Be aware that you must be able to respond quickly and get to any center within hours if one becomes available to you. It is up to the patient to reach out to additional transplant centers in their area. They may or may not allow you to list with them as well. 

Until it is your time to receive an organ, you are expected to follow physician’s orders and take good care of yourself. And even though it may not benefit you directly, perhaps encouraging everyone you know to become an organ donor could help someone else on the list. 

Sources 

“Frequently Asked Questions”. UNOS. https://unos.org/transplant/frequently-asked-questions/#Waiting 

“Our Global Network of Partners”. National Marrow Donor Program. https://www.nmdp.org/what-we-do/partnerships/global-transplant-network 

“Sign Up To Be An Organ Donor”. Health Resources & Services Administration. https://www.organdonor.gov/sign-up