The current system needs to be improved so that geographic disparities in waiting times are minimized and access to donated organs is equalized. According to a 1998 report of waiting list activity, waiting times for blood type O patients needing liver transplants can range from a median of 46 days in Iowa to 596 days in neighboring Nebraska to 721 days in western Pennsylvania. For kidney transplants, the median waiting time is about 100 days in Oregon and more than 1,600 days in New York City. Because of disparities in waiting times, patients with means and resources are encouraged to list at multiple centers in order to increase their odds of being transplanted. According to UNOS, about 4,200 patients are currently listed at multiple centers.
More patients die waiting for transplants each year.
In 1998, more than 1,300 died waiting for liver transplants, nearly 200 more than in 1997. A total of 4,855 died waiting for organ transplants in 1998, an increase from the 4,313 who died the previous year. A number of states have recently passed laws to assure that organs donated in their states are offered first to patients listed at centers there. Such laws disadvantage those residents who are listed elsewhere. Children may be particularly disadvantaged by the current system, because priority given to local use of donated organs can deny children in other regions organs from pediatric donors.