University of Virginia Health System

Liver Transplantation

Waiting for an Organ: The Listing Process

The waiting list for transplant organs is managed nationwide by a federally regulated, non-profit service called the United Network for Organ Sharing (UNOS) . UNOS uses a complex set of factors to ensure that availability and distribution of organs is handled fairly and promotes the greatest benefit from a precious medical resource.

When a patient’s name is added to the waiting list for a liver, blood type, antigens identified in the blood and other information are entered into a computer registry that is maintained by UNOS. Candidates awaiting a liver transplant are assigned a status code derived from a mortality risk score corresponding to the degree of medical urgency, referred to as MELD/PELD scores (The Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease). Livers will be offered to candidates with the highest medical urgency based on these scores, with the candidate having the highest probability ranking receiving the highest priority before being offered to patients having lower probability rankings. Geographic factors are also taken into consideration. For more information about MELD/PELD scores, please see the UNOS Allocation of Livers Policy.

The Effect of Living Donation on Wait Time

A liver for transplantation may come from a living or deceased donor. Living donors often come from a patient’s family; sometimes they are found among close friends. One benefit from living donation is in the shorter waiting time to surgery and the ability to schedule surgery to accommodate the needs of the recipient and donor. Because the transplant operation can be handled as an "elective" surgery, plans can be made well in advance. In addition, a liver from a living donor will likely function longer than one from a deceased donor.  

The waiting time for a liver varies a great deal from patient to patient. In some cases a liver transplant will occur within a month or two of listing; in others the patient may wait for a year or two.

The transplant surgery must occur within hours of the organ becoming available. Patients must be accessible to the clinical staff during the waiting period in order to ensure that an offer of a suitable organ can be finalized and a transplant operation completed in the shortest possible time.