Liver Transplant Waiting List

If you are a candidate for a liver transplant, you will be added to the national United Network for Organ Sharing (UNOS) deceased-donor liver transplant waiting list. This milestone marks the next phase of your journey, during which you will wait for your new liver. 

While you wait for your new liver:

• Your transplant coordinator will schedule follow-up appointments based on your personal needs.
• You will see your primary hepatologist for continued care based on your personal needs.
• You'll have access to ongoing education while awaiting your transplant.

Start Your Transplant Journey

How Do You Get on The Liver Transplant Waiting List?

To be placed on the UNOS liver transplant waiting list, you first need to receive a referral from your physician and select the hospital where you would like to receive your transplant. You can also refer yourself by contacting a member of our liver transplant team. 

After a referral is submitted, a member of the transplant team will contact you to discuss next steps. This will include scheduling a time for you to come to the hospital for evaluation.

After your evaluation is complete, the members of the transplant team will discuss your case and decide if a liver transplant is in your best interest. After the transplant team decides that a liver transplant is the best option, you will be added to the national waiting list.

What disqualifies you from being on the liver transplant list?

You may be disqualified from being on the liver transplant waiting list if you have:

• Active infections.
• Active substance abuse, such as alcohol and drug use.
• A high risk of surgical complications due to illness or frailty.
• An inability or unwillingness to follow your pre- or posttransplant treatment plan.
• A recent history of serious medical conditions, such as certain types of cancer.
• A severe, untreated psychiatric disorder.
• Severe obesity.
• Uncontrolled diabetes.

How Long Is The Waiting List for a Liver Transplant?

Donor liver availability is difficult to predict, so wait times for a liver transplant vary. Factors that may affect your wait time include:

• Blood type.
• Geographic area where you live.
• Height and weight.
• Placement status on the waiting list.

How Is My Placement Status on the Liver Transplant Waiting List Determined?

The Organ Procurement and Transplantation Network (OPTN) decides the criteria for those selected for the liver transplant waiting list.

Liver transplant candidates, ages 18 and older, will receive a Model for End-Stage Liver Disease (MELD) score between 6 and 40.

Liver candidates can be assigned any of the following MELD statuses:

• Status 1A — Sudden and severe onset of liver failure and life expectancy of hours to days without a liver transplant.
• Calculated MELD score — MELD score calculated from lab values. This score is updated periodically while awaiting transplant.
• MELD exception score — MELD exemptions may be granted for the following conditions: hepatocellular carcinoma, cholangiocarcinoma, cystic fibrosis, hepatopulmonary syndrome, familial amyloid polyneuropathy, and certain other disease-specific conditions.
• Inactive status — Temporarily ineligible for a deceased-donor liver transplant.

Your MELD score determines your priority on the transplant waiting list. Your MELD score reflects the likelihood of death within three months.

The higher your MELD score, the higher priority for receiving a donor liver when one is available. The allocation system ensures that candidates with the highest MELD scores — between 30 and 40 — get a transplant first.

Becoming inactive on the liver transplant waiting list

Surgeons must transplant a donor liver within a certain amount of time. You will always need to be within four to six hours of the hospital while you're on the liver transplant waiting list.

You will need to inform your transplant coordinator of any travel that will take you outside the four- to six-hour window. If you must travel, we may place you in an inactive status on the list. Upon returning to the area, please notify your transplant coordinator to return your status to “active." This may require updated blood work to recalculate your MELD score, depending on your current condition.

Other reasons for inactive status include:

• Needing further tests.
• Having health problems that might increase your risk of complications during or after transplant surgery.
• Not following the treatment plan or waiting list rules provided by your liver transplant team.

You will not be penalized if you choose to change your status to inactive.

What to Expect When Waiting for Your Donor Liver

Here are a few things you need to know while you wait for your donor liver:

Stay close to the hospital

While waiting for a liver transplant, remaining close to the hospital is crucial. When your coordinator calls, you will need to get to UPMC for your liver transplant within four to six hours.

Family House provides an affordable “home away from home" for liver transplant patients and their families.

Learn more about traveling to Pittsburgh for transplant services.

Maintain your health

After you are on the waiting list, your liver transplant coordinator will schedule you for follow-up appointments based on your overall medical condition and MELD score.

You will need to have blood work periodically to reevaluate your MELD score and be seen in the clinic at least every six months so the team can assess how ready you are for a transplant.

Most patients continue to see their primary hepatologist for follow-up care during this waiting time. Your doctor will remain in contact with the transplant team at UPMC, in addition to your regularly scheduled visits at UPMC.

What to Expect When Your New Liver Becomes Available

When a liver becomes available, your transplant coordinator will call you with instructions. Remember to keep your phone on and ready for incoming calls at all times.

While you travel to UPMC, a member of UPMC's liver transplant team will evaluate the donor organ.

If the liver is a match for you, we'll prep you for surgery as soon as you arrive at the transplant unit.

Why Choose UPMC for Liver Transplant Care?

 When you choose UPMC for liver transplant care, you will receive:

• Access to experienced, board-certified specialists — UPMC’s liver surgeons have pioneered minimally invasive (laparoscopic) liver surgery and have performed this technique more than 250 times — making them one of the most experienced teams in the United States.
• Expert care for complex cases — Our program is one of the oldest and largest in the United States. Since the program's inception in 1981, more than 6,000 adults have received liver transplants. This experience allows us to treat patients with complex liver conditions, including those with advanced liver cancer.
• Personalized liver transplant care — From thorough evaluation to world-class treatment, we provide a patient-centered approach to care throughout the entire transplant process. Your dedicated transplant team will guide and support you each step of the way.

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By UPMC Editorial Staff. Last reviewed on 2025-12-09.