How much donor supply does your transplant center actually see?
Under the OPTN 2020 liver-allocation policy, a donor liver is offered first to candidates whose transplant center sits inside a 150-nautical-mile circle drawn around the donor hospital, then within 250 NM, then 500 NM. The more donor hospitals near your center, the more offers your center sees — one of the strongest reasons two patients with the same MELD wait very different lengths of time.
This page shows the donor-hospital count inside each acuity circle for every U.S. adult liver transplant program, alongside the center's SRTR-reported median wait. Sortable; data is real and current.
What is an acuity circle, in plain language?
Before 2020, liver allocation in the United States was organized around Donor Service Areas (DSAs) and 11 OPTN regions — geographic blocks with sharp borders. A patient on the wrong side of a line could be just a few miles from a busy donor hospital but ineligible for its offers. The 2020 acuity-circle policy replaced that with concentric distance circles drawn around each donor hospital.
When a donor liver becomes available, the OPTN system runs an offer sequence. The first tier of candidates considered are those listed at transplant centers within 150 nautical miles (about 173 statute miles) of the donor hospital. If no candidate at that distance is a match, the offer expands to centers within 250 NM, then 500 NM, then beyond. Inside each circle, sickest patients (highest MELD) are offered first.
What that means for a patient choosing a transplant center: the donor-hospital density inside your center's 150-NM circle is, mechanically, the first determinant of how many offers your center will see. State borders, OPTN region borders, and old DSA lines are no longer the operative geography — circles are.
Donor supply by transplant center
Counts include every geocoded donor hospital that contributed to a U.S. liver recovery during the cohort window (March 2025 – February 2026). The "median wait" column is the SRTR-reported median time to transplant for adult listings at each center, except where a center has supplied its own figure — those rows are marked center-reported and show the center's number in place of the SRTR median, matching the comparison table on Compare Centers.
| Transplant center | State | ≤ 150 NM | ≤ 250 NM | ≤ 500 NM | Median wait |
|---|---|---|---|---|---|
| Loading donor-supply data… | |||||
Tap any column header to sort. Click MMAT Topography for a deeper view of what kind of donors fall in each acuity circle — not just how many.
How to read this table
A high donor count inside the 150-NM circle is good news — but it isn't the whole story. Three other forces shape your actual wait:
- How many patients are on the list at your center. A center inside a donor-dense region with 600 candidates competes harder for each offer than a center with 80 candidates in the same region.
- How sick those patients are (the MMAT distribution). If most candidates at a donor-dense center are at very high MELD, offers are absorbed by them before they reach lower-MELD patients. The MMAT Topography page shows this distribution explicitly.
- What organs your center accepts. Programs differ on willingness to use older donors, donors with hepatitis-C exposure, DCD (donation after circulatory death), and split or living-donor grafts. Two centers inside the same circle can see the same offers and accept very different proportions of them.
A short way to use this page well: pair the donor-supply count with the median-wait column for the same center. If you see high donor supply paired with a long median wait, that tells you patient volume or acceptance criteria are the binding constraint, not organ supply. If you see low donor supply paired with a short median wait, that's typically a smaller program in a sparser region — competition is light because the candidate list is small.
Limits of this view
- Donor counts are great-circle (haversine) distances, not driving distances — they match how the OPTN allocation system calculates the circle, not how organs travel in practice. Most organs travel by air for circles > 150 NM.
- Status-1 (acute fulminant) candidates are eligible for national offers regardless of distance. They are not subject to the acuity-circle ordering.
- Pediatric allocation circles are broader and use different rules. This page covers adult programs; see the pediatric comparison for that population.
- Donor-hospital coordinates are geocoded from OPTN-published facility addresses with a four-tier confidence ladder (HIGH / MEDIUM / LOW / NONE). Counts above use only HIGH and MEDIUM matches; the "donor count" in the snapshot includes all confidence levels, the "high-confidence count" excludes the bottom two tiers. See methodology below.
- Wait-time medians are SRTR-reported for the cohort window shown in the snapshot header. They do not include patients still on the list, only those who reached transplant.
About this content & methodology
Data sources: Donor hospital coordinates are derived from OPTN-published facility records (Provider of Services file from CMS, OPTN member directory, HIFLD geocoding ladder). Acuity-circle distances are great-circle (haversine) computations between donor hospital and transplant center coordinates, matching the OPTN policy definition. Median wait time is SRTR-reported time to transplant for adult listings, or the center's own reported figure where one has been supplied (see the center-reported marker).
Cohort window: The cohort window for donor-hospital median MELD at transplant is shown in the snapshot header above (March 2025 – February 2026 at the time of writing).
Methodology: Donor hospitals with valid geocodes (any of HIGH, MEDIUM, LOW confidence
tiers) are joined to every transplant center by haversine distance and bucketed into the OPTN bands
(≤ 150 NM, ≤ 250 NM, ≤ 500 NM, > 500 NM). The counts you see are precomputed in our
mmat.center_donor_isobar rollup, which is regenerated when either the donor-hospital
file or the transplant-center location table changes.
Reviewed by: the National Friends Medical Advisory Board. Underlying clinical and registry sources (OPTN, SRTR, UNOS) are referenced on the advisory board page. Not medical advice — always consult your transplant team. The acuity-circle allocation system is also subject to revision by OPTN; this page reflects the policy in force as of the cohort window shown.
Last reviewed: 2026-05-26
Related pages
Public information only. Not medical advice. Center-specific listing eligibility, insurance acceptance, and clinical fit decisions remain with your transplant team.