US transplant system offers ways to improve odds

Patients hoping to receive a transplant often discover that the path to surgery is not simply a matter of patience. In the United States, the transplant system shows wide variation across hospitals, and many patients learn that asking targeted questions can move the needle. Katherine Screws of Phoenix, who received a rare intestine transplant, found that placing herself on the waiting lists at more than one hospital increased her chances.

How the system works

To help patients navigate these differences, the Scientific Registry of Transplant Recipients (SRTR) has introduced patient‑friendly tools that let people compare centers by volume, waiting times, and outcomes. The database lists the highest‑to‑lowest‑volume hospitals for each organ and offers personalized decision guides that factor in age, blood type and health conditions. These tools aim to make the complex data accessible to patients making high‑stakes choices.

At any given time, about 100,000 people are on the U.S. transplant waiting list, most of whom need a kidney. Just over 49,000 transplant procedures were performed last year, reflecting a decade of growth in donations from deceased donors recovered by organ procurement organizations (OPOs). Demand remains high, and transplant programs differ in their eligibility criteria, leading to a 16‑fold variation in how quickly patients receive a kidney at some centers compared with others.

Patients can adopt several tactics to improve their odds. One approach is double‑listing, where a patient registers at a nearby center and at a higher‑volume program farther away. Another strategy is to explicitly ask a transplant team about the likelihood of acceptance and the criteria they use; conversations can prompt a program to take more aggressive offers. Using the SRTR tools, patients can compare outcomes for groups similar to themselves, such as older adults or people with diabetes, and choose a center that matches their profile.

How to improve chances

By combining data‑driven research with proactive communication, patients can potentially shorten the time they spend waiting and increase the chance that an organ will become available for them. The new tools and the willingness of patients to explore multiple options give hope that the transplant system can better meet the needs of those on the waiting list.