Accepting or declining an offer for a liver

Your liver transplant team will support your decision-making and guide you through the offering process

Key points

There may not be much time to decide whether a donated liver is suitable for you or not
Sometimes, there may be issues with the donor or organ that mean that the organ has a higher risk of failure or disease transmission than you or your transplant team are willing to accept
You may have problems, such as a recent infection, that makes you unsuitable to undergo transplantation at that time
It is up to you and your transplant team to decide whether to accept or decline an offer

Understanding the risks

Receiving an offer for a liver can bring about a rollercoaster of emotions. You may have been waiting a while for this moment and be desperate for the transplant to go ahead. But before it can, your transplant team needs to assess the likely risks and benefits of the offered liver and discuss these with you.

Every deceased donor and every liver are different. Some livers carry more risk than others. Sometimes the liver you are offered may carry a higher risk than either you or your transplant team are willing to accept.

Learn about the risks from a donated liver

Accepting an offer

If your transplant team thinks that an offered liver is suitable for you, they will tell you relevant information about the donor and the organ.

The transplant team are not able to give you all of the information that they have about the donor. The donor’s name and personal details must be kept confidential. But you will be told if the donor has significant health problems that could affect how well the organ works after transplantation. Or if there are risks of transmitting infections or cancers.

If you decide to accept the offer and proceed with the transplant, you will be asked to come into the transplant centre.

View British Transplantation Society consent guidance (PDF 114KB)

Declining an offer

If you feel the organ is not right for you, you should decline the offer. The transplant centre will not force you to accept an organ offer. The transplant team is there to support you in your decision.

If you turn down an offer for a reasonable reason then you will remain active on the transplant waiting list if you are otherwise well enough for a transplant.

Acceptable reasons for refusing an offer include:

Concerns about the risk of getting disease from the donor
Concerns about the liver being higher risk for possible complications
Concerns that the liver may not function for long enough

If the transplant team has concerns about the reasons for you turning down an offer, they may want to talk to you further. Your place on the transplant waiting list may be put on hold until this has happened.

Answers to common questions

How do you decide whether to accept or decline an offer?

We understand this is a very difficult decision. Your transplant team will advise you as much as possible and encourage you to discuss your options with family and friends.

Often, there may not be much time to decide whether a liver is suitable for you or not. The transplant team might only be able to give you an hour or less to make this decision. They will tell you if this is the case.

Your decision often depends on how much risk you are prepared to take. Some patients on the transplant list are likely to receive many liver offers, while other patients will rarely receive a liver offer. Some patients have major problems that mean the risks and benefits are different for them. Therefore, some patients are willing to accept more risk with their transplant than others.

This is a personal choice and your transplant team will support whatever decision you make.

What happens if your transplant team feels that a liver offer isn’t suitable for you?

If your transplant team decides that an offer is not suitable for you, they will turn down the offer for you.

Some patients want to be told about all liver offers that are made to them, even if the transplant team thinks that the liver being offered isn’t suitable. Please let your transplant team know if you want to be told about all offers, even if it means waking you at late at night.

Most patients prefer not to be contacted by the transplant team if the team thinks the offer isn’t suitable for them. For these patients, they only want to be phoned with an offer if the transplant team thinks that it is a reasonably good organ for them.

Please let your transplant team know which approach you would prefer.

How long will I have to wait for another offer if an offer is declined for me?

The wait for an organ is not a queuing system and you won’t go ‘to the back of the queue’. It’s a case of waiting to see when you’re matched to another suitable donated liver. How long this will be is hard to say as it depends on many different factors. Your transplant team will tell you which is more likely, but it is not possible to accurately predict when you will receive another offer.

Learn how the organ offering system works

Can I change my mind about having a transplant?

What happens if I feel unable to accept certain donated livers?