Liver Transplant Centers Vary in Accepting Organ Offers—and That Impacts Patient Survival

person holding cooler next to stretcher

Patients on liver transplant waitlists are offered organs sequentially; the sickest patients in a local area are at the top of the waitlist and receive the highest priority. Although intuitively one would expect all transplant centers to be equally likely to accept a liver for their patient at the top, there were no data that had addressed whether this was the case. Furthermore, it was unknown how a center's decisions to accept or decline donor livers impacted whether patients at that center would subsequently die.

The authors examined data on all organ offers over a six-year period to evaluate factors associated with an organ offer being accepted, and how the probability an organ offer for a given patient would be accepted differed from center to center. The study shed light on a previously unidentified source of disparity in liver transplantation: transplant centers vary widely in the organs they accept, leaving many of the sickest patients to die while awaiting a life-saving organ. Even within a given local geographic area, some centers were far more likely to accept an organ, regardless of how sick the patient was.


David S. Goldberg, Benjamin FrenchJames D. Lewis, Frank I. Scott, Ronac Mamtani, Richard Gilroy, Scott D. Halpern, Peter L. Abt