More than 100,000 people are on the organ donor wait list—here's who has the longest and shortest wait times
This story originally appeared on Northwell Health and was produced and distributed in partnership with Stacker Studio.
More than 100,000 people are on the organ donor wait list—here's who has the longest and shortest wait times
When non-surgical medical intervention is no longer enough for patients with missing or damaged organs, organ transplantation can become their best chance for life-sustaining care. A transplant is a procedure in which an organ is surgically taken from a donor and transplanted in a recipient to give a better chance to live longer, healthier, and better than they would have with their own organs. According to data from the Centers for Disease Control and Prevention, the most commonly transplanted organs in the country are the kidney, liver, heart, lungs, pancreas, and intestines.
Limited supply and high demand can contribute to lengthy wait times for organ transplants. On an average day, there are approximately 100,000 individuals actively waiting for an organ transplant in the U.S. Meanwhile, there were only about 14,000 deceased organ donors per year as of 2021— each giving around 3.5 organs to recipients—and about 6,000 organs made available each year by living donors, according to the CDC.
Wait times for organ transplants are more than a simple supply-demand issue. Not all donor organs are compatible with recipient bodies. Hence, organizations like the United Network for Organ Sharing (OPTN) find the optimal donor and recipient match based on logistical and medical criteria. For some organs, distance from the donor hospital is a significant factor in matching organs since the organs are viable only for a short period outside of the body.
The quickest way to get a transplant is to join the waiting list. To better understand wait times and the logistical needs of donor matching, Northwell Health partnered with Stacker to compile a list of median organ transplant wait times for each organ using patient data collected by the Organ Procurement and Transplantation Network between 2012 and 2021. Data was last updated on May 19, 2023.
OPTN does not provide median waiting times for kidney transplants but rather competing risk probability, which calculates mortality and other hazards for possible outcomes. As a result, kidneys are not included in the list.
Heart transplant
- Median waiting time, 2012-2021: 190 days (44,395 registrations added)
- Annual statistics
--- Median waiting time, 2017: 230 days (4,536 registrations added)
--- Median waiting time, 2018: 191 days (4,711 registrations added)
--- Median waiting time, 2019: 107 days (4,717 registrations added)
--- Median waiting time, 2020: 77 days (4,594 registrations added)
--- Median waiting time, 2021: 81 days (5,008 registrations added)
Heart transplantation is a complex medical operation involving the surgical transfer of a healthier heart from a donor to a recipient suffering from a heart ailment. The organ is donated after the donor has been declared brain-dead or deceased. According to the U.K.'s NHS, heart transplantation is prescribed when other remedies for treating heart disease don't work, leaving the patient's life at risk. Illnesses that might eventually require a heart transplant include coronary heart disease, failing or weakened heart muscles, and congenital heart disease.
During the surgery, doctors put the recipient under anesthesia and use a heart-lung bypass machine to keep pumping blood through the body and brain while they remove the recipient's heart. The donor heart is then connected to the major veins and arteries. Factors determining the compatibility of a donor's heart include blood type, body size, and medical urgency, according to the American Heart Association.
As with any major open-heart surgery, there are risks involved, though medical advancements have continued to increase survival rates—even when accounting for more older and higher-risk patients receiving new hearts. Rejection of the donor heart is one of the biggest concerns after organ transplants, and immunosuppressant drugs and frequent post-operative biopsies help doctors monitor issues. Advancements in medication, including monitoring for side effects and helping support a weakened immune system, have made a difference in improving success rates. According to the Mayo Clinic, the one-year post-transplant survival rate for adults is 90% worldwide, and 80% after five years.
Heart and lung transplant
- Median waiting time, 2012-2021: 393 days (565 registrations added)
- Annual statistics
--- Median waiting time, 2017: 332 days (47 registrations added)
--- Median waiting time, 2018: 463 days (67 registrations added)
--- Median waiting time, 2019: 182 days (65 registrations added)
--- Median waiting time, 2020: 114 days (80 registrations added)
--- Median waiting time, 2021: 143 days (67 registrations added)
A heart and lung transplant is a medical procedure in which the recipient's heart and lungs are replaced with the donor's heart and lungs in the same operation. There are generally few organ pairs suitable for the procedure, and such a major operation is generally considered after all other treatment options are considered. The level of complexity and expertise needed to perform such procedures is another reason that such surgeries are rare. Heart and lung transplants are decided on by a team who determines if the recipient is compatible with the donor organ pair on criteria such as medical history, body size, and a variety of fluid and function tests, along with X-rays and scans.
The organs are donated by a recently deceased or brain-dead donor. Patients must be carefully monitored once the operation is done and should consult a physiotherapist for cardiopulmonary rehabilitation to improve the strength of their new organ pair.
Intestine transplant
- Median waiting time, 2012-2021: 255 days (1,641 registrations added)
- Annual statistics
--- Median waiting time, 2017: 260 days (161 registrations added)
--- Median waiting time, 2018: 234 days (139 registrations added)
--- Median waiting time, 2019: 285 days (103 registrations added)
--- Median waiting time, 2020: 395 days (144 registrations added)
--- Median waiting time, 2021: 477 days (142 registrations added)
Intestine transplantation is the process by which either a portion or the entire gastrointestinal tract (which starts at the esophagus and includes the small intestine, bowel, and large intestine) is removed and implanted in the recipient. Intestine transplants are needed after intestinal failure or for diseases like short bowel syndrome or intra-abdominal tumors. In very rare instances, a segment of an intestine can be donated by a live donor, but almost always the donor is deceased.
Before the transplant, to assess suitability for the operation, doctors carries out blood tests to examine the recipient's liver function, electrolytes, and kidney function, and to see if the recipient suffers from infections like HIV or hepatitis. They would also carry out X-rays of the chest, CT scans of the abdomen, ultrasound scans of the liver, a colonoscopy, and lung-function tests to determine recipient suitability.
During an intestinal transplant operation, doctors would perform an ileostomy to create an opening through which digestive waste can exit the body through an external pouch. Once the transplant team determines that the transplanted intestine is healthy, the ileostomy could be closed to allow waste to flow naturally.
Kidney and pancreas transplant
- Median waiting time, 2012-2021: 650 days (13,350 registrations added)
- Annual statistics
--- Median waiting time, 2017: 533 days (1,257 registrations added)
--- Median waiting time, 2018: 405 days (1,295 registrations added)
--- Median waiting time, 2019: 547 days (1,479 registrations added)
--- Median waiting time, 2020: 589 days (1,314 registrations added)
--- Median waiting time, 2021: 660 days (1,488 registrations added)
A kidney and pancreas transplant occurs in one operation. According to the National Kidney Foundation, this operation is prescribed for those who suffer kidney failure due to type 1 diabetes, when their kidneys are unable to filter wastes and their pancreas cannot regulate insulin production.
In this type of operation, the kidney could come from a living or deceased donor, while the pancreas comes from a deceased donor. Before the transplant, patients must take blood tests, urine tests, heart and lung function tests, eye and dental exams, and neurological tests to determine suitability for the operation. Due to significant innovations in this procedure, the organization notes that pancreas-kidney transplants have reached a survival rate of 95% one year post-surgery and 92.5% three years after surgery. Within one year after the operation, there is also an 80% to 85% chance that the recipient will not need dialysis or insulin treatments.
Liver transplant
- Median waiting time, 2012-2021: 433 days (126,714 registrations added)
- Annual statistics
--- Median waiting time, 2017: 402 days (12,947 registrations added)
--- Median waiting time, 2018: 368 days (13,147 registrations added)
--- Median waiting time, 2019: 345 days (13,448 registrations added)
--- Median waiting time, 2020: 257 days (13,019 registrations added)
--- Median waiting time, 2021: 239 days (13,833 registrations added)
Responsible for filtering toxins, producing bile, and processing hormones and nutrients, the liver is critical to help your body regulate immune responses. Liver transplants are recommended for people in the end-stage of liver diseases and at risk of liver failure. In 2021, there were more than 9,200 liver transplants in the U.S., making it the second-most common organ transplant after kidneys.
Patients may need liver transplants if they have alcoholic liver disease, cancers beginning in the liver, fatty liver disease, and chronic hepatitis C-induced cirrhosis. A transplantation team will carry out psychological evaluations, blood tests, and diagnostic examinations to ascertain suitability for the operation. While survival rates may vary, its estimated to be 75% for at least five years after surgery.
Lung transplant
- Median waiting time, 2012-2021: 79 days (28,110 registrations added)
- Annual statistics
--- Median waiting time, 2017: 79 days (3,000 registrations added)
--- Median waiting time, 2018: 76 days (3,204 registrations added)
--- Median waiting time, 2019: 68 days (3,248 registrations added)
--- Median waiting time, 2020: 42 days (2,675 registrations added)
--- Median waiting time, 2021: 46 days (3,091 registrations added)
For patients with diseased or failing lungs due to pulmonary disease, scarring in the lungs, cystic fibrosis, and other severe conditions, a transplant is often the last option. In the U.S., there were more than 2,500 lung transplants performed in 2021, according to the OPTN.
There are three kinds of lung transplants: a single lung transplant, a double lung transplant, and a heart-lung transplant. Sometimes, a living person can donate one lung to a recipient, but generally donors are deceased. The NHS notes that one of the main constraints in lung transplants is that the recipient and donor must be of the same blood type.
Lung transplant recipients have a one-year survival rate of 89%, but with a five-year survival rate of about 60%, the procedure remains one of the most challenging types of transplant operations for patients. A lower long-term survival rate that falls behind other organ transplants is due to about half of patients developing chronic lung allograft dysfunction—a severe condition resulting from tissue rejection—within five years of undergoing a transplant. However, advancements in lung transplantation have increased the odds of survival, and better postoperative monitoring, medications, and donor selection continue to improve postoperative care and our understanding of how to increase lung function.
Story editing by Brian Budzynski. Copy editing by Esprit Smith. Photo selection by Clarese Moller.
