Dr. Sridhar Tayur
Professor, Carnegie Mellon University; Founder, OrganJet

Mediaplanet: How can transplant patients benefit from “listing smartly?”

Dr. Sridhar Tayur: There are two main considerations beyond cost: outcomes, that ensure a good and long post-transplant life, and wait times to obtain a transplant. By selecting a transplant center “smartly,” patients can reduce their wait times and improve outcomes.

MP: How does geographical location affect an organ transplant?

ST: The wait times are strongly correlated to geography. In New York, New Jersey, Boston, Atlanta, Chicago and Los Angeles, the wait times for kidney and liver transplants are very high compared to those at centers elsewhere. Patients in the high wait areas can list in a center with low wait in other geographies, depending on their insurance coverage and ability to travel or move.

MP: How can one find a low wait transplant center near their home?

ST: The data is available publicly through Scientific Registry of Transplant Recipients' website and is updated periodically.

MP: What can early transplantation mean for patients?

ST: In the case of kidney transplantation, you could get a transplant before you even go on dialysis. If you are already on dialysis, earlier transplantation has two benefits: better outcomes and less time on dialysis. It is also important to know, for kidney patients who have been on dialysis for a while or have been listed in one center for a while, they can transfer this wait time so far to a different center and so take credit for "time served." For a liver patient, getting a transplant at a lower Model for End Stage Liver Disease (MELD) score also means better outcomes and less inconvenience during pre-transplant time. In all cases, the outcomes are better and life before and after transplant is better. Listing in more than one place is allowed and patients should look into the many benefits of multiple listing.

MP: What is the average time a patient who lists “smartly” waits for an organ compared to other patients?

ST: This can vary significantly from region to region. Generally speaking, a patient can reduce the wait time by at least two years, and in some cases, even more for a kidney transplant. For liver transplants, one can get the transplant at a lower MELD score. Research has shown that access to transplantation increases nearly 100 percent by multiple listing smartly.

GIVING MEANS LIVING: Irena Bucci, a Washington, D.C. resident, wife and mother of two after her transplant in Pittsburgh with Dr. Tayur.

MP: Once a patient is informed of their match, what is the process he or she will go through next?

ST: They need to get to the transplant center in six hours for liver or under eight hours for kidney. They can drive, like some have from New Jersey to Pittsburgh, or fly commercial, as some have down from New York City to Kansas City or Washington, D.C. to Pittsburgh. Some others have moved to a new location when they hear that they are near the top of the list, like one patient who worked in Connecticut, but got her liver transplant in Indianapolis. A private jet is a good back-up option; many have used it for liver transplantations, flying from San Francisco to Portland, for example, and many of these costs are covered by insurance.