United Network of Organ Sharing (UNOS) Transplant - Waiting List

Once your child's name is placed on the computerized national waiting list to receive an organ, you may feel like your family has moved from one period of uncertainty to another. On one hand, your child has been diagnosed, and you now know that he or she needs a transplant to stay healthy. On the other hand, there are many other people on the list, so it may take months or even years to receive a transplant. At the same time, at any moment you may get a call from your transplant coordinator telling you to come to the hospital right away because an organ is available.

The organ transplant waiting period can be a very difficult time for your entire family, with so many questions about the future up in the air. One thing you may wonder about during this time is how it is decided which person on the list will receive a donor organ first. Below is some information about the national organ transplant waiting list.

Organ Waiting List Myths and Misconceptions

There are plenty of myths and misconceptions about the organ donation waiting list. One of the most common is the belief that the famous or rich make it to the top of the list faster than others. This is not true. According to The United Network for Organ Sharing (UNOS), the nonprofit charitable organization that maintains the nation's organ transplant waiting list under contract with the Health Resources and Services Administration of the U.S. Department of Health and Human Services, the organ allocation system is "blind to wealth or social status." Who gets a particular organ is based on a number of factors, including blood type, severity of illness, age, gender, race, etc.

Registering with UNOS

Once accepted onto the STI waiting list, your child is registered with UNOS, which operates a central computer database that links all Organ Procurement Organizations (OPO) and transplant centers. OPOs are the link between the donor and recipient; they and are responsible for retrieving, preserving, and delivering the organ.

The UNOS network is operated 24 hours a day, with specialists evaluating the various criteria as soon as an organ becomes available. While the local surgical team extracts a donor organ, the local procurement organization enters all the information about the organ into the UNOS database. The computer then matches the various factors (blood and tissue type, for instance) in order to identify matches with potential recipients.

Finding an Organ Match

Once matching recipients are found, the list is further narrowed by applying additional criteria, such as severity of illness, length of time on the waiting list, and distance between the recipient and donor organ. One exception to distance considerations is the kidney, which is sent to the best matched patient, regardless of location. This is a result of organ preservation time.

Various organs are preserved until transplantation by a variety of means, and the length of time an organ can remain outside the body varies. According to UNOS, organ preservation times are:

• Heart: 4–6 hours
• Liver: 12–18 hours
• Kidney: 48 hours
• Heart-Lung: 4–6 hours
• Lung: 2–4 hours
• Pancreas: 12–18 hours

Learn more about the UNOS Waiting Period.