You have the right to ask another center to evaluate you.

What you are allowed to do

Getting evaluated by a second transplant center is not unusual, not disloyal, and not against any rule. The transplant system in the United States is built around patient choice. These are the things you are allowed to do as a patient or caregiver:

• Request a second evaluation. You can call any transplant center in the country and ask to be evaluated, whether or not you are already listed somewhere else.
• Be listed at more than one center. This is called multi-listing or dual listing. UNOS policy permits it. See our dual-listing guide for how it works.
• Request your full medical records. You are entitled to a copy of your chart, imaging, pathology, labs, and transplant evaluation notes. Centers are required to release them to you or to another center you designate.
• Ask why a listing decision was made. If you were not listed, taken off a list, or told you are not a candidate right now, you can ask for the reason in writing. You can also ask whether the decision is appealable within the center.
• Bring a caregiver or advocate. You are allowed to bring someone to every appointment, including the evaluation interview, and to have them speak on your behalf.
• Contact UNOS Patient Services directly. If you need help navigating your rights or have a concern about a transplant program, you can call UNOS at 888-894-6361.

Questions to ask a second center

When you call another transplant center for an evaluation, these five questions will help you and that center’s team understand your situation quickly and compare it to your current plan.

1. How does your program weigh MELD score against overall clinical history?

   Why it matters: Centers vary in how much emphasis they place on the raw MELD number versus the pattern of decompensation (bleeds, encephalopathy, ascites, portal hypertension). A center that looks at the full clinical picture may reach a different listing decision.

2. Will my case get an independent review, or will you mostly rely on records from my current center?

   Why it matters: A genuine second opinion involves independent clinical judgment, not just a records review. Ask whether you will be seen by their hepatologist and surgeon, and whether their selection committee will review your case fresh.

3. What are your current wait times and transplant rates for someone in my situation?

   Why it matters: Wait times, transplant rates, and organ acceptance practices vary meaningfully between centers. You can also compare programs yourself on our Compare Centers page, using public SRTR data.

4. Do you accept patients who are multi-listed, and how does that work for you?

   Why it matters: Not every center actively supports dual-listing, and logistics (travel time to the center, coordination with your home program, insurance) matter. Ask how the center handles multi-listed patients in practice.

5. What is your center’s waitlist mortality rate, and how do you handle patients who decompensate while waiting?

   Why it matters: Waitlist mortality rates can look better if patients are removed from the list when their condition declines. That is sometimes the right clinical call, and sometimes it is not. A center that answers this question directly is signaling how it thinks about patients who get sicker while waiting. Ask for specifics.

How to request a second evaluation

The steps below are the same whether you are starting fresh or already listed somewhere:

1. Get your records. Call the medical records department at your current transplant center and request a full copy of your chart: evaluation notes, imaging, pathology, labs, and any selection-committee letters. Federal law entitles you to this. You can have the records sent to you, or directly to another center.
2. Find another center. Use public data to identify one or two programs that make sense for your geography, insurance, and clinical situation. Our Compare Centers page shows wait times and transplant rates sourced from SRTR for every adult liver program in the country.
3. Call the transplant coordinator directly. Every program has a transplant coordinator whose job is to screen new patients and schedule evaluations. Tell them you are seeking a second evaluation, that you have your records, and ask what their intake process is. Write down the coordinator’s name and direct line.
4. Bring someone with you. Evaluations are long, emotionally loaded, and technical. Bring a caregiver, family member, or advocate who can take notes and ask follow-up questions. Two sets of ears is standard practice.
5. If you hit a wall, contact UNOS. If a center will not return your calls, will not release your records, or will not give you a clear answer about your status, you can call UNOS Patient Services at 888-894-6361. They can help you understand policy and escalate if needed.

What National Friends does and does not do

We are a patient-advocacy organization. We help families organize what to do next — calling centers, gathering records, asking the right questions. We do not replace your transplant coordinator or your clinical team.

• We do not determine candidacy or make listing decisions.
• We do not provide medical advice.
• We do not direct treatment or tell a center how to evaluate you.

Emergency guardrail: If someone is in immediate danger, call 911 now. If you need to talk to our support team, see Support.

Resources

• UNOS (United Network for Organ Sharing) — Organ transplant policy, data, and Patient Services (888-894-6361).
• OrganDonor.gov — Federal organ donation information.
• SRTR (Scientific Registry of Transplant Recipients) — Transplant program data used on our Compare Centers page.
• Transplant Living — Patient education and support.