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Welcome to our question and answer page for multiple listing and waiting time transfer.
Below is commonly requested information to assist you. If you have other questions or comments, contact the Organ Procurement and Transplantation Network (OPTN) Patient Services line at (888) 894-6361 or submit them here.
How am I listed for a transplant?
If you have a condition leading to organ failure, your doctor may refer you for an organ transplant. A transplant hospital will evaluate you to see if an organ transplant is an option for you. It is up to each hospital to decide whether it will accept someone as a transplant candidate. (More information on the listing process is available at organdonor.gov.)
How am I considered for organs from deceased donors?
You are matched with organ offers based on a combination of medical factors entered into a computerized matching program. These factors include:
- Blood and tissue type
- Medical urgency
- Donor height and/or weight
- Distance between the donor and transplant hospital
- Time spent waiting for a transplant
Because organs can only be preserved for a short time from donation to transplant, the matching system considers the distance from the donor hospital to the transplant hospital where a patient is listed. A shorter
distance means a shorter amount of time the organ must be preserved. This makes it more likely the transplant will be a success.
What is multiple listing?
Multiple listing involves registering at two or more transplant hospitals.
In general, candidates listed at hospitals closest to the donor hospital will get more matching priority than other candidates who are in similar medical condition, but listed at transplant hospitals farther away.
Could multiple listing shorten my waiting time for a transplant?
Some studies suggest multiple listing can shorten the average waiting times of kidney transplant candidates by several months. This does not mean that every person who does so will have a shorter waiting time.
Many factors affect how long you might wait for a transplant. Of course, not enough organs are donated each year to meet everyone’s needs.
Everyone in the transplant community shares the goal of increasing organ donation to save and enhance more lives.
Other factors considered in organ matching include:
- How urgent the patient’s need is
- Donor height and/or weight
- Blood type
Some kidney and pancreas candidates have a “highly sensitized” immune system because of prior transplants, pregnancy, or multiple blood transfusions. Highly sensitized patients will only be good matches for a limited number of organ offers, so they often wait longer than non-sensitized candidates.
Are there any restrictions?
Multiple listing is allowed by OPTN policy. However, it is up to each hospital to decide whether to accept you as a candidate.
It is not likely to increase your matching priority if you list at multiple hospitals in the same city or neighboring cities. This is because each organ is matched by the relative distance from the donor hospital to the transplant hospital, so differences of a few miles between transplant programs likely would not have a major effect.
Some transplant programs may not accept multiple-listed patients. Others may set their own rules for multiple-listed candidates. If you want to be listed at more than one hospital, you should ask the transplant team how they handle such requests.
Also, your medical insurance may not cover transplantation at all transplant programs. In some cases they may cover transplant costs but at a reduced rate of coverage.
What is involved in multiple listing?
As with any transplant listing, a transplant hospital must consider and accept you. You must complete an evaluation and agree to meet any conditions set by the program (for example, being able to come to the hospital within a certain time if you are called for an organ offer).
Check with your insurance provider to see if they will provide coverage for treatment at another hospital. If so, ask if they will cover the cost of additional evaluations.
You also should think about other costs insurance may not cover. For example, you may need to pay for travel and lodging if the hospital is further from your home. You also should find out whether you will need post-transplant medical care at the transplant hospital or whether you can be transferred closer to your home.
In addition, you need to make sure each transplant program where you list has your current lab results and contact information. Each program will need current information should they receive an organ offer for you. Through the OPTN database, your program can know if you are multiple-listed, but may not know the other hospital(s) where you are listed.
If I list at more than one hospital, how is my waiting time considered?
Depending on the organ you need, waiting time may be a factor in matching you for an organ offer. Waiting time is a more important factor for certain organ types, such as kidney and pancreas. It is less of a factor with heart, lung, liver, and intestinal organs. For these organs, factors such as medical urgency are more important than total waiting time.
If you are listed for a kidney transplant, you get credit for waiting time from when you start dialysis to treat kidney failure. Your waiting time will be the same at each transplant program where you list, as long as each program has the same information about when you started dialysis.
If you are listed for any other organ type, your waiting time at each hospital will start from the date that program listed you. The longest amount of time you have waited at any hospital is called your “primary waiting time.”
OPTN policy allows you to transfer your primary waiting time to another hospital, or to switch time between programs, if the programs agree as well. (For example, if you waited 9 months at Hospital A and 6 months at Hospital B, you could switch to have 6 months at Hospital A and 9 months at Hospital B.)
You are not allowed to add up or split your total waiting time among multiple hospitals. (Again, assume you have waited 9 months at Hospital A and 6 months at Hospital B. You could not assume you have 15 total months of waiting time and assign 5 months to Hospital A and 10 months to Hospital B.)
Any request to transfer or switch waiting time must be approved by the transplant program(s) involved. Most transplant programs require a written request to swap or transfer waiting time, which is then considered by the transplant team.
If I do not multiple-list but transfer my care to another hospital, what happens?
If you want to end your listing at one hospital and transfer to another, your primary waiting time can be transferred as long as you coordinate with both programs. The new transplant program will likely ask you to submit a written request to transfer the waiting time. Keep in mind that if you end your listing at one program before another program accepts you, you may risk losing all previous waiting time.
Sometimes a transplant program may stop doing transplants for a period of time (for example, to replace a key member of the transplant team who leaves) or close its operations. If this happens, the OPTN requires that the program contact you and provide for your continuing care. If the inactivation is short-term, you may choose to remain listed until the program becomes active again. However, you will not receive organ offers during that time. If the program closes, the staff will work with you to arrange care at another hospital without loss of your primary waiting time.
Where can I get additional information?
You should first contact the staff of the transplant program where you are listed or want to be listed. They can explain how they handle requests for multiple listing and/or waiting time transfer. They also will make any needed arrangements with the OPTN.
You may also wish to visit the OPTN website or the Organ Transplant Process webpage on Organdonor.gov. If you have other questions or comments, contact the OPTN Patient Services line at (888)-894-6361.
* Note to transplant candidates and family members:
In accordance with OPTN policy, your transplant hospital is required to provide you with written information about multiple listing and transferal of waiting time.