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Understanding the Liver Transplant Waiting List

With more than 14,000 people currently on the liver transplant waiting list, the need for organ donors grows every day. Despite increased awareness of organ donation and the pressing need for donors, people with end-stage liver disease continue to die while on the waiting list because an appropriate match wasn’t found in time.

If you’re in need of a liver transplant, time spent on the waiting list can be stressful and confusing. That’s why it’s important to understand how the waiting list works, how organs are matched and allocated, and how living liver donation can greatly reduce your time on the waiting list.

Learn more about the transplant process from UPMC Transplant Services.


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Model for End-Stage Liver Disease

If you’re placed on the liver transplant waiting list, your doctor will give you a score between six and 40. This is called your Model for End-Stage Liver Disease (MELD) score, and it’s based on your current health status and how urgently you need a transplant.

The MELD score determines your rank on the transplant waiting list and reflects the likelihood of death within a three-month period. The higher your MELD score, the more likely you are to receive a deceased donor liver when one becomes available.

While on the waiting list, you must undergo follow-up appointments and blood work every few months to re-evaluate your MELD score. Any changes could affect your priority on the list and when you’ll receive a transplant.

Related: Life After Becoming a Living Donor

How Are Organs Matched?

When an organ becomes available, several factors determine how that organ is matched to someone on the waiting list, including:

  • Age
  • Blood type
  • MELD score
  • Waiting time
  • Geographic distance between donor and recipient
  • Size of the donor organ in relation to the recipient

To start, anyone on the waiting list who isn’t a match for a donated organ is removed from the list of potential recipients. Once the list is condensed, the organ is matched with a recipient based on medical compatibility.

A donor liver can be preserved for eight to 12 hours, so geography, timing, and distance from the hospital are very important. The United States is divided into 11 geographical zones to help regulate transplantation and organ allocation. Each transplant center is part of one of those 11 zones. When a donor liver becomes available in one of the 11 zones, people on the waiting list within that region are screened to determine who’s the best match.

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Living Liver Donation: A Life-Saving Solution

Depending on the MELD score, people remain on the transplant waiting list until a deceased donor becomes available. Because there aren’t enough deceased donor organs available to meet the growing demand, approximately 25 percent of people on the waiting list die before receiving a transplant.

Living-donor liver transplants save lives by allowing recipients to receive a transplant sooner. Additional benefits of living donation include:

  • Little or no wait time
  • Quicker recovery time
  • Improved long-term outcomes

When it comes to living-donor liver transplants, early evaluation is key so it’s important to explore this option as soon as possible.

To learn more about what to expect on the liver transplant waiting list or living donation, please visit the Liver Transplant Program at UPMC.