Dual Listing

Dual listing, sometimes called multiple listing, involves registering at two or more transplant centers. Since candidates at a center local to the donor hospital are usually considered ahead of those who are more distant, multiple listing may increase the chances of receiving a local organ offer.

Here is a list of Frequently Asked Questions and Answers on dual listing and how it helps organ donor recipients.

How am I considered for organs from deceased donors?

You are considered for available organs based on a combination of factors that are entered into a computerized matching program. These factors include blood and tissue type, medical urgency, body size, distance between the donor and transplant hospital, and time spent waiting for a transplant.

The distance between the donor and transplant hospital is important because the less time the organ must be preserved outside the donor’s body, the better the chance it will function when transplanted.

There are three levels considered:

  • Local. This is usually the area served by the local organ procurement organization (OPO) where the donation occurs. There are 58 OPOs nationwide. These areas are often statewide but can be smaller (such as a large city or part of a state) or larger (a multi-state area). Your transplant center can tell you what your local area is.
  • Region or zone. If there are no suitable local matches, organs are offered to patients at transplant centers throughout the region. Kidneys, livers, pancreases and intestinal organs are first offered within one of 11 regions of the United States. Heart and lung offers are considered for candidates within 500 miles of the donor site, then 1,000 miles, then 1,500 miles.
  • Nationwide. If there are no matches in the local area or region, organs will be offered to anyone in the United States who is a potential match.
Dual listing is also commonly called multiple listing. What is it?

Dual, or multiple listing is when a transplant candidate registers at two or more transplant centers.

Because candidates at centers close to the donor hospital are usually considered before those further away, multiple listing may increase the chances of receiving a local organ offer.

Could multiple listing shorten my waiting time for a transplant?

Some studies suggest multiple listing can shorten the average waiting times of kidney transplant candidates by several months. This does not guarantee every multiple-listed patient will have a shorter waiting time because many factors affect how long you might wait for a transplant.

Waiting time factors include how urgent the patient’s need is, and how closely the donor and candidate match in body size and blood type. Some kidney and pancreas candidates have a “highly-sensitized” immune system because of earlier transplants, pregnancy or multiple blood transfusions. Highly-sensitized patients will be good matches for a limited number of organ offers, so they often wait longer than non-sensitized candidates.

There is a nationwide shortage of donated organs, which means there are not enough available organs to meet everyone’s needs. Everyone in the transplant community shares the goal of increasing organ donation to save and enhance more lives.

Are there any restrictions?

Organ Procurement Transplant Network (OPTN) policy allows multiple listing, but the individual center decides whether or not to accept you as a candidate. You probably would not benefit from listing at multiple centers in the same local allocation area (which is usually the OPO) because waiting-time priority is first calculated among candidates at all hospitals within the local donation area, not for each hospital individually.

Some transplant programs may not accept multiple-listed patients, while others may set their own requirements for multiple-listed candidates. If you are considering multiple listing, ask the transplant team how they handle such requests.

What does multiple listing involve?

As with any transplant listing, you must be considered and accepted by a transplant center. You will complete an evaluation and agree to all conditions set by the program, such as your ability to come to the hospital within a certain time if you are called for an organ offer.

Check with your insurance provider to see if the cost of additional evaluations will be reimbursed. You should also consider other costs associated with listing that insurance may not cover. For example, you may need to pay for travel and lodging if the center is far from your home.

You should also find out if your post-transplant medical care will be provided at the center or can be transferred to a facility closer to your home. In addition, you must maintain current lab results and contact information for each transplant program where you list because they will need current information if they receive an organ offer for you. Through the OPTN database your center can know if you are multiple-listed, but may not know the other hospital(s) where you are listed.

For additional information about multiple listing please contact your transplant coordinator (Brenan or Rachel) at (217) 788-3441. Or download a brochure from UNOS on multiple listings.