Accepted as a Liver Transplant Patient
If you and the transplant team decide that transplantation is the best treatment for you, you will be listed with the
United Network for Organ Sharing (UNOS). UNOS administers and maintains the computerized national organ transplant waiting list. You will join a list of people waiting for a liver donation from a deceased donor.
The New England Organ Bank (NEOB) is the local (regional) organ procurement organization (OPO) for Beth Israel Deaconess Medical Center and the rest of New England, and coordinates sharing organs through UNOS. Staff at NEOB will enter your medical information into a computer and will notify our transplant team when an organ becomes available based on your MELD score (which measures the severity of your liver disease), waiting time on the list, blood type and size match.
There is no guarantee when a deceased liver will become available. It could be months or years. The average waiting time for a deceased donor liver in New England is about one year; however, prioritization for liver transplantation depends on severity of liver illness rather than waiting time. The waiting time is longer for patients with blood type O or B, and shorter for patients with blood type A or AB.
For more about wait time, and other statistics, visit
The Scientific Registry of Transplant Recipients. The SRTR publishes center-specific reports with a wide range of useful information about transplant programs operating in the United States. The information includes many features of the BIDMC transplant program, such as the number of transplants performed in recent years, waiting time and waitlist outcomes, and the post-transplant experience of our patients. The statistics allow comparisons to national averages, as well as to the experience for similar patients at other centers in the country. The waitlist report is based on BIDMC data for patients transplanted within the last five years.
Patients may choose to be listed at more than one transplant center, in different UNOS regions. Multiple listings may increase your chances of receiving an organ offer. UNOS operates the organ procurement and transplantation network (OPTN), and OPTN policy allows you to multiple-list at more than one transplant center as long as the centers you choose are not in the same local area. The Transplant Institute at BIDMC does accept multiple-listed candidates but not all transplant programs do.
UNOS has prepared a special brochure describing all that is involved with multiple listings, including completing an evaluation at each program, and checking with your insurance provider to be sure any additional evaluation costs are covered.
UNOS requires that transplant programs provide a telephone number so that patients can contact UNOS if they have grievances or concerns about multiple listings or any aspect of their transplant care. We are pleased to provide this number, which is in keeping with Beth Israel Deaconess Medical Center's focus on transparency, and our commitment to providing high quality care to the patients and families we are privileged to serve. You can reach UNOS toll free at 888-894-6361.
In Close Touch
While you are waiting for a liver to become available, you will visit the Transplant Institute every one to six months, or sometimes more often, so we can closely monitor your physical and emotional well-being. As always, we encourage you to invite a loved one to these appointments.
Our goal is to work with you to keep you as healthy as possible. During your regular visit to the Transplant Institute we will screen for and treat any new complications, and if necessary, adjust your place on the waiting list according to your MELD score.
The United Network for Organ Sharing (UNOS) has developed an objective way of scoring the severity of a patient's liver disease to predict who needs a liver transplant most urgently. Called the MELD score, which stands for Model for End-Stage Liver Disease, it takes into account three specific laboratory measurements:
- Serum creatinine (measure of kidney function)
- Serum bilirubin (measure of liver function)
- INR (measure of clotting function)
UNOS uses a statistical formula based on these three routine laboratory tests to compute the MELD score, which predicts a patient's risk of dying while on the waiting list. The higher the numerical score, the more urgent the patient's need is for transplantation. This score is then used to prioritize the organ waiting list so that the sickest people are transplanted first.
The MELD score's numerical scale ranges from 6 (patients who are less ill) to 40 (patients who are gravely ill). A patient's MELD score can change a number of times, based on the progression of his or her liver disease. Research has shown that the MELD formula, which is a simple and objective measurement, is a consistently accurate prediction of patients' short-term mortality risk without a transplant.
UNOS and your transplant team can provide you with more information about the MELD score, including how waiting time is counted when your MELD score fluctuates.