Double Listing: a Promising Option for Patients on Liver Transplant List
Education & Research Out of the 15,000 patients diagnosed with end-stage liver disease and waiting for an organ, 9,000 won’t receive one. Half that number will die or be removed from the transplant list.
"Liver transplantation is more like an emergency room where the sickest patients are triaged first," admits Dr. Rolf Barth, Director of Liver Transplantation at the University of Maryland Medical Center. According to Rolf, the biggest challenge is patients can’t wait to get their turn. “There’s an equal chance they won’t survive.”
Patients register with multiple transplant centers, a process called double or multiple listing, to shorten the waiting time. Wait time is the time between when a person is placed on the organ transplant list and receives a transplant. There is no conclusive data that double listing reduces wait times.
Patients don’t benefit from double listing within the same organ donor service area because they are drawing from the same pool of organs. “If you’re the sickest one at your center, it doesn’t make a tremendous difference to double list,” says Dr. Barth, noting the sickest patients are the ones at the top of the transplant list.
"Patients register with multiple transplant centers, a process called double or multiple listing, to shorten the waiting time."
Placement on the transplant list is based on the patient’s Model for End-Stage Liver Disease (MELD) score, which ranges from 6 to 40. The individual score determines a patient’s ranking; the higher the score, the greater the chance of dying within the next three months.
Wait times vary based on the geographic region, up to four or five years in some areas. “It’s supply and demand,” states Dr. Richard Formica, American Society of Transplantation Councilor-at-Large and professor of medicine and surgery, Yale University. For example, she points out, New York and California have much longer wait times than the Southeast.
Dr. Josh Levitsky, American Society of Transplantation Councilor-at-Large and associate professor at Northwestern University Feinberg School of Medicine, said a lot of patients couldn’t travel between different transplant centers. Patients have four to five hours once they receive the call to travel to the transplant center.
Ultimately, he says, “Double listing is an individual decision for patients and their families.”