What Makes a Match for Liver Transplant? Discover the Criteria

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Over the past several years, there has been a rash of liver transplant stories showing up in the news and on medical dramas on television. What is the truth about liver transplants and what makes a match for liver transplant?

Because the liver is responsible for key functions in the human body such as breaking down proteins, metabolism, bile production, nutrient storage and detoxification, a failing liver may need to be replaced.

A failing liver can be replaced in two ways. The first is with the transplant of the entire organ. The second is with the transplant of a small portion of a liver, also called a liver graft.

Liver Transplant Matching Criteria

According to USC’s patient guide, the very first things looked at when matching an organ from a deceased donor are the blood and tissue type, condition and size of the organ. This information is then given to the United Network for Organ Sharing (UNOS), which operates the national organ donation patient waiting list.

Patients on the waiting list are matched, in order of need, with organs that match their blood and tissue type, as well as size needed. For example, a child would need a smaller organ than an adult.

Location of the donated organ in relation to the patient is a factor as well, because organ viability is limited once the organ is removed from the donor. This means that someone lower on the list may get a donation sooner, simply because they are the best match for the organ, within the region of where it is located. Transplant surgery is taken seriously and every effort is made to ensure the best possible chance of success for organ recipients.

Liver Transplant Recipient Criteria

The patient’s guide from USC also lists some factors, from UNOS, that are considered before a patient may receive a donated organ. They include:

The condition of the patient. If a patient develops an illness or otherwise is too weak or ill to operate on, they may not receive an organ at that time, though they can remain on the waiting list.

The condition of the donor and donated organ. There may be factors such as diabetes or injury that can prevent a donated organ from being accepted or from being given to any particular recipient. This includes viability factors such as how long the organ has been outside the donor’s body and any possible problems that occurred in-transit with the organ.

Pre-surgery compatibility testing. Prior to surgery, tests are done to ensure the condition of the organ for the recipient. These final matching tests may reveal unknown problems that make the organ unsuitable for a particular recipient.

Location. As mentioned previously, location can also be a critical factor in whether a matching organ may be used for any particular donor. Time is of the essence and there is a limited amount of viability with donated organs. This is a factor considered by the transplant surgical team, as well as UNOS.

For More Information

To learn more about what makes a match for liver transplant, organ donation, patient waiting lists and UNOS, refer to the UNOS website.


Digestive Diseases: Liver Transplantation. Reviewed by Venkat Mohan MD on September 13, 2008. Last editorial review December 11, 2009. https://www.medicinenet.com/liver_transplant/article.htm

A Patient’s Guide to Liver Transplant Surgery. The USC Liver Transplant Program. https://www.surgery.usc.edu/divisions/hep/patientguide/index.html