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What You Need to Know About the Liver Transplant Waitlist Process and Waitlist Times

Doctor and nurse discuss medical chart with patient in a hospital bedOnce you are approved to join the liver transplant list and an authorization has been obtained by your insurance, you will be placed on the liver transplant waitlist maintained by the United Network for Organ Sharing (UNOS). The waitlisting database is called the Organ Procurement and Transplantation Network (OPTN).

Waitlist times and placement on the list are determined by certain factors, including:

  • MELD-Na SCORE or Model for End-Stage Liver Disease
  • Weight
  • Blood type

Your MELD-Na score will be based on these lab values:

  • Bilirubin, which indicates how effectively your liver is excreting bile
  • INR (prothrombin time), which indicates how well your liver can make blood clotting substances
  • Creatinine, which reflects your kidney function (kidney impairment often occurs alongside severe liver disease)
  • Sodium, which reflects your body's fluid balance

MELD-Na scores can range from six to 40; the higher your MELD score, the more urgent your need for a transplant. If you know your values for these lab values, you can enter them here to calculate your MELD score. However, please note that your score may go up or down with each lab draw.

Your coordinator will update your MELD score in UNOS after you have your blood work done. It is essential that laboratory testing is completed on time to maintain your status on the list. The list changes frequently as new patients are added, other patients are transplanted, and MELD scores are adjusted.

Patients with the most urgent need will be considered first as organs become available. The only exceptions are for patients in the category of status 1A, indicating acute (sudden and severe onset) liver failure and a life expectancy of a few hours to a few days without a transplant. Learn more about liver allocation here.

What’s Expected from Waitlist Participants

liver referral form buttonWhile you wait on the liver transplant list, it is important to keep in close contact with the transplant center and your assigned coordinator. You will also need to continue seeing and communicating with other providers involved in your care such as your primary care physician and your gastroenterologist. Coming to the clinic for follow-up appointments with your coordinator and hepatologist will also be very important as you wait. Your coordinator will let you know how frequently your laboratory testing will need to be completed, and depending on your wait time, routine radiology and cardiac testing may also need to be updated. Your coordinator will work with you to let you know which testing can be completed closer to home.

To view questions that patients who are on the waiting list frequently ask, click here.

If you are hospitalized at another facility during the time that you’re on the waitlist, if your contact information has changed, if your insurance information has changed, if you are moving or going out of town, or if any major updates regarding your healthcare status occur, please contact the liver transplant office at (813) 844-7137 as soon as possible.