FAQs

What is the national transplant list?
The federal government established the The United Network For Organ Sharing or UNOS to develop and maintains the national transplant list.  This is an online database system, called UNet℠ , which collects, stores, analyzes and publish all data that pertains to the patient waiting list, organ matching, and transplants.  It is used to match donated organs to waiting recipients on the lists.  UNOS is operated under federal contract which is administered by the Department of Health and Human Services’  Health Resources and Services Administration (HRSA).  When one lists for transplant, he/she is placed on this national list, along with the information needed to match donated organs to waiting patients.

How does the transplant list work?

For kidney transplants, an individual’s position on the list is based on when they were added to the list.  For other organs there are additional criteria which affect a person’s position on the list.

How are kidneys allocated?

Kidneys are allocated to a recipient within its geographic region, by blood type, based on the quality of the match and then the position on the lists.  Howver, should there be a perfect match anywhere in the United States, the donor kidney will go to that person and be sent to  sent to that individual’s transplant center. Individuals names are masked; everything is done by numeric identifier.

Is my position on the national list my position at every transplant center at which I list?

No, your position on the national list is established at the first transplant center at which you list.  In addition to the national waiting list, each transplant center maintains its own waiting list and your position on that list will be determined by the date you are approved for their waiting list. UNOS allows a one time only transfer of waiting time from one center to another.

Can I list at multiple transplant centers?

It is your legal right to list at multiple transplant centers and this may reduce the time you have to wait to receive a transplant.  Be sure to check with your insurance provider to determine what their policies are.  Most support transplants beyond your local region, but have only certain approved centers.  Most patients who pursue multiple listing will have

If a kidney is found for me, where will I have the surgery?

If you list at one or transplant centers in other cities, should a kidney be offered to you from one of those centers, and you accept the offer, you will travel to that center for the transplant surgery. You must be available to leave immediately for the center, as the surgery will need to be done as soon as possible.  If a kidney is not able to be placed within its deceased donor’s geographic area, then if it is matched to you, it will be sent to the transplant center where you are listed

Why should I list for transplant?

Dialysis is not a 100% replacement therapy for kidney failure.  While it removes most of the toxins, it does not remove all of the toxins from your blood that are a by-product of metabolism.  A transplant provides your body with a functioning kidney and for most people, their lab results return to normal range after a kidney transplant.

When should I list for transplant? You should list for transplant as soon as your GFR hits the level of 20%.  As your GFR approaches this number, you should have standard screening tests done and copies of the reports, so when you hit the pre-requirement number, you can complete the listing process as quickly as possible.

When does dialysis typically start?

When dialysis starts is based on a number of factors, but generally starts when a patient has reached a GFR of 12-10. This is done at the direction of the patient’s physician.
Why list before dialysis has started (known as preemptive transplant or PRT)?

A Medscape article which reviewed several peer reviewed medical journal articles states that, “Several investigations utilizing national data from the United States have repeatedly confirmed the survival advantages of PRT for adults compared with transplantation after dialysis initiation, and that increasing duration of pretransplant dialysis is associated with increasing risks of mortality and allograft failure. It goes on to state that the “survival advantage was not limited to the short-term but increased over time post-transplant.”

Can any hospital do a kidney transplant?

Transplants can only be done at one of the 270 accredited transplant centers. Not every transplant center has a program for every organ.

Are transplant performance statistics available?

Yes, the government maintains statistics on survival of transplant patients and their transplanted organ, also known as a graft at the Scientific Registry and is accessible to everyone.

Are waiting times available by transplant center?

You can contact transplant centers in your area and ask them what their waiting time is for your blood type. You can also ask them about their success rates for host and graft survival at one year and three years.

Where can I access data from a number of transplant centers?

This information can be found at the OPTN website under the Data section.  There are a number of canned reports, but you can also create a custom report to look at specific information, such as waiting time by organ, by  blood type.

What tests are required by transplant centers as part of the evaluation process?

Each transplant center establishes its own criteria for accepting someone into their transplant list.  Frequently, you can find this information on a transplant center’s website.  Along with a standard set of tests, based on your own medical situation, other tests may be required.