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The Organ Transplant Waiting List: How to Get Added, and What Comes Next

UAB Medicine is an excellent choice for those who need an organ transplant. Not only are we one of the most advanced and active transplant centers in the nation, our success rates are high, and we offer many innovative ways to help match deceased-donor and living-donor organs with patients who need them.

We work closely with the Alabama Organ Center (AOC), which in 2016 opened a Donor Recovery Center that helps save lives by increasing the number of organs recovered for transplant and making the process faster and more seamless. The AOC is one of very few organ procurement organizations in the nation with an in-house recovery center. [MT1] In addition, UAB Medicine has consolidated its organ transplant efforts into the UAB Comprehensive Transplant Institute (CTI), which over the past half-century has pioneered many changes, including groundbreaking research, new medications, and innovative treatment techniques.

The information below explains the basics of how patients are added to the transplant waiting list, how the matching and selection process works, and what is required of patients.

Referral to UAB Medicine

If you or a loved one is suffering from organ failure and your physician has recommended an organ transplant, the first step toward getting on the transplant waiting list is obtaining a referral from that physician. Once UAB Medicine receives the referral, our transplant team will contact you to discuss your specific medical needs, insurance, finances, support group availability, and other matters involved in beginning the evaluation process.

Evaluation for Transplant

The next step involves an evaluation to determine candidacy for transplant. Certain medical conditions may rule out a transplant, such as a recent cancer diagnosis, morbid obesity that may preclude surgery, or long-term dependence on certain medications. Depending on the medical issues involved, our program may ask another specialist to examine you and advise whether transplantation would be a safe option. In some cases, even if a transplant program doesn’t accept you immediately, it may reconsider later if those mitigating conditions improve.

Getting Added to the Waiting List

If it is determined that you are a good transplant candidate, you will be added to the national waiting list maintained by the United Network for Organ Sharing (UNOS), a private, nonprofit organization that manages the nation’s organ transplant system under contract with the federal government. UNOS will not notify you when you have been added to the list; instead, your transplant center will notify you within 10 days to let you know that you have been listed and on what date. If you have questions about your status on the list, you should ask your transplant coordinator.

Multiple Listings

UNOS policy permits patients to be added to the list at multiple transplant centers. By being evaluated and listed at more than one transplant center, you may be considered for organs that become available in other areas. This may reduce waiting time in some cases. There is no advantage to listing at more than one transplant center within the same Organ Procurement Organization local area. Each center has its own criteria for listing transplant candidates, and some will not accept patients seeking to list at multiple centers.

Waiting for a Match

Once you are added to the national organ transplant waiting list, you may receive an organ almost immediately, or you may wait many months or even years. Factors affecting the wait time include how well you match with available donors, how sick you are, and how many donors there are in your local area compared to the number of patients waiting.

When a transplant hospital adds you to the waiting list, your information is placed on the national transplant list with all other candidates waiting. When a donor organ becomes available, all of the patients on the list are compared to that donor. Individual factors such as medical urgency, time spent on the waiting list, age, organ size, blood and tissue type, and genetic makeup are considered. The organ is offered first to the candidate who is the best match. Organs are distributed locally first, and if no match is found, they are then offered regionally and even nationally until a recipient is found. Every effort is made to match each donor organ with an appropriate recipient.

Transplant Expenses

Some transplant patients struggle with the cost of a transplant or related expenses such as travel, lodging, and post-transplant medications. A number of local, regional, and national organizations provide some assistance with these costs through grants or services. At the individual level, community organizations or faith groups may be willing and able to help raise money, while friends and family members often solicit funds through public events or online appeals. Your transplant financial coordinator can discuss insurance and funding options with you. 

Learn more about UAB Medicine’s Comprehensive Transplant Institute and how you can share the gift of life by becoming an organ donor.