If you're waiting for an organ transplant, you may wonder if there’s a way to improve your chances of receiving an organ sooner. One option is multiple listing.

Multiple listing involves joining more than one transplant center’s waiting list at the same time. It can expand access to organ offers and reduce wait times. But it isn't practical for everyone.

Learn more about how multiple listing works and what you should consider before multiple listing.

What Is Multiple Listing?

Multiple listing is when you register for an organ transplant at more than one transplant center.

Every transplant center maintains its own waiting list. The United States allows you to be active on multiple lists at the same time. It's the only known country to allow multiple listing.

The Health Resources and Services Administration (HRSA) manages the Organ Procurement and Transplantation Network (OPTN). An OPTN policy gives you the right to register at more than one transplant center for the same organ. This applies to all organs, including kidneys, liver, heart, lung, pancreas, and intestine.

You can choose centers in different cities, states, or regions, but each center has to evaluate you independently. Once approved, you receive a separate listing at that center. They'll share your medical information through OPTN but track your waiting time and status individually.

How Does Multiple Listing Work?

To join more than one wait list, HRSA requires you to complete the full evaluation process at each transplant center. This includes medical tests, imaging, lab work, and meetings with the transplant team.

It's possible for one center to approve you but not another. Hospitals have their own individual criteria for approving transplant candidates.

Some centers don't accept multiple-listed candidates at all. It's important to check with a transplant center about their policies for multiple listing. At UPMC, we do accept multiple-listed candidates.

If multiple hospitals approve you:

  • Each center lists you separately.

  • You receive a unique waiting time at each center.

  • You stay active on all lists unless a center changes your status.

  • Your updated medical information goes through OPTN.

Why Do People Choose Multiple Listing?

The main reason why people choose multiple listing for an organ transplant is that wait times vary by transplant center. Some centers have shorter wait times because of:

  • Center size and transplant volume — Larger centers or centers that perform more transplants may have faster processes and more organ offers.

  • Differences in organ availability — Some regions have more donated organs than others.

  • Local patient populations — The number of people waiting in a certain area can affect how long it takes to receive an offer.

  • Organ acceptance practices — Some centers accept organs that others decline.

  • Regional donation patterns — Donation rates often vary by region.

Multiple listing doesn't guarantee a faster transplant. But it does increase your chances of getting an organ sooner.

What Should I Consider Before Joining More Than One List?

Multiple listing isn't the right choice for everyone. Yes, it can offer more opportunities to secure the organ you need. But it also comes with additional responsibilities, costs, and logistical challenges.

Costs

Multiple listing can increase your expenses. Insurance may not cover travel, lodging, meals, or repeated medical evaluations. Visiting multiple transplant centers may also require you to take more time off work or pay for help at home.

Be sure to ask each transplant center about financial counseling. They can explain what your insurance covers and help you understand what out‑of‑pocket costs you could face.

Follow-up care

Some transplant centers require in-person follow‑up visits after surgery, even if you live far away. These visits may be frequent in the first weeks and months after transplant and can exacerbate travel costs.

Make sure you understand each center’s expectations beforehand, including:

  • How long you'd need to stay in the area following surgery.

  • How often you'd need to return for checkups.

You may be able to transfer your follow-up care closer to your home. But check with the transplant center for their policy on this.

Medical stability

You must be healthy enough to travel safely to a transplant center far away. If your condition changes quickly or if you have trouble moving around, long‑distance travel may not be safe for you.

Your transplant care team can help you determine whether your health even allows for multiple listing.

Support system

Most transplant centers require you to identify a care partner. This person does more than support your posttransplant recovery. Care partners are with you throughout your transplant journey.

If you receive a transplant far from home, you'll need a care partner who is able to travel and stay with you after surgery. They may also need to help manage your recovery if you're far from your usual care team.

Travel

You must be able to travel quickly when a center calls with an organ offer. Some centers expect you to arrive within hours.

This can add stress to an already stressful situation, especially if you live far away or your health makes travel difficult. You also can't control factors that may impede travel, like weather or traffic.

Many people choose to stay in temporary housing near a center to make travel easier. Multiple listing can make this challenging and also add to the cost and planning.

What Are My Rights as a Transplant Candidate?

HRSA outlines important rights that help you stay informed and in control during the transplant process. Understanding these rights can make it easier to make decisions that support your health and your future.

As a transplant candidate, your rights include the following:

  • You can ask for information about wait times and outcomes — Every center must give you clear information about how long people usually wait and how well people do posttransplant. This helps you compare centers and make informed choices.

  • You can choose where you want to receive care — This doesn't have to be the closest transplant center or the one that referred you. You can explore other programs, ask questions, and decide which center feels right for you.

  • You can list at more than one transplant center — You have the right to join multiple wait lists if you choose. This can give you access to different regions, different wait times, and more opportunities for an organ offer.

  • You can request copies of your medical records — Your records belong to you. You can ask for them at any time. You can also share them with other transplant centers.

  • You can transfer your waiting time between centers — If you switch transplant centers or add a new one, you can request that your waiting time move with you. This protects the time you’ve already earned and helps you avoid starting over.

You're in control of your listing decisions. Your transplant team should support you, answer your questions, and give you the information you need to make confident choices.

At UPMC, we are a national leader in organ transplants. We have performed more than 20,000 transplants since 1981 and are a leader in transplant research. For more information on our program, visit our website.