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Liver waiting list simulator Simple version

How the liver waiting list works, and what changes it

Scroll. Each step adds one idea and one thing you can change. At the end you compare your choices with the UK as it is now. About five minutes, built from published UK figures rather than real patients.

1

The list

About 610 adults are waiting for a liver transplant in the UK at any one time. Each dot is a person. Further right means they have waited longer; higher means they are more unwell.

People join every week, and people leave: most by transplant, some because they recover enough to come off, and some because they die or become too unwell for an operation.

Time on the list → How unwell → Woman in her 60s Quite unwell · waiting 3 months
2

Livers arrive

Each month about 84 livers are retrieved from donors around the UK. Around 1 in 5 turns out not to be usable. Try changing the number and watch the month fill up.

95
60▲ UK now 84110
You moved it to 95. Your choice carries through the rest of the story.
Usable: about 76 Not usable: about 19 About half come from DCD donors
3

A rule decides who is offered it

When a liver becomes available it is offered to one person at a time, in an order set by a rule. The UK rule estimates who would gain the most from this particular liver. Choose a rule and see the order change.

The rule decides who is offered the liver. How people fare without a transplant is estimated separately, by a survival model, and the rule does not change that.

Offer order for one liver · most benefitDonor in their 50s · DBD · blood group O
1stWoman in her 60s · quite unwell · waited 3 monthsOffered · accepted
2ndMan in his 50s · very unwell · waited 2 weeksWould be offered next
3rdMan in his 40s · moderately unwell · waited 7 months
4thWoman in her 30s · moderately unwell · waited 1 month
5thMan in his 60s · less unwell · waited 11 months
Under "longest waiting first" the 5th person would be offered it first. Under "most unwell first", the 2nd.
4

A year later

Follow 100 people who join the list under your choices. This is where they are a year on.

Your choices95 livers a monthMost benefit

Average of 10 runs. The number transplanted ranged from 67 to 72.

69transplanted
19still waiting
5removed from the list
7died or became too unwell for a transplant
5

Your choices against the UK now

The same 100 people and the same donor livers, run twice: once as the UK is now, once with your choices. Any difference comes from what you changed.

Change your choices above ↑
UK now63 · 24 · 5 · 8
Yours69 · 19 · 5 · 7
+6 transplanted−5 still waiting−1 died or too unwell

With 95 livers a month, six more people in every 100 are transplanted within a year. Nationally that is roughly 55 more transplants a year.

6

Go further

Try a questionSix ready-made experiments, one change each. Open the labAll the levers at once, with pinned comparisons. How it was checkedThe model compared with published UK figures, line by line.

For education and research only. Must not be used to make or influence decisions about any individual's clinical care, listing or organ offers. Built by the Edinburgh organ allocation research group.