Nine organ offers for an Arizona woman were declined in 2024 before she received an intestine transplant, The Associated Press reported, illustrating how hospital decisions can shape transplant waits.
The Health Resources and Services Administration (HRSA) says a hospital's willingness to accept organ offers is one factor in how long a patient waits. Compatibility, medical urgency, time on the waiting list and the distance between donor and hospital also affect matching.
Lisa Stocks of organ procurement organization OneLegacy told AP that nine offers for Katherine Screws had been declined during 2024. AP reported that Screws, a Phoenix resident, eventually received an intestine transplant at MedStar Georgetown University Hospital in June 2025.
A car crash in May 2022 had led to the removal of Screws' small intestine, leaving her reliant on intravenous nutrition, AP reported. Her first hospital had suggested a wait of about six months. The transplant came more than three years after the crash.
Screws was still listed at UCLA Health when Georgetown added her to its waiting list weeks before surgery, according to AP. UCLA told AP it follows federal transplant guidance and would not discuss her case because of patient privacy. Screws asked AP, “What is the thing that's holding this up?”
Patients may seek places on multiple waiting lists, but each hospital decides whether to list them, HRSA says. Another listing may require a separate evaluation and bring travel or lodging costs, depending on insurance coverage. It does not guarantee an earlier transplant.
The Scientific Registry of Transplant Recipients publishes activity and outcome data for intestine transplant centers. It cautions that the figures cannot identify the best center for an individual patient.
Federal payment policy now measures offer acceptance at some kidney transplant hospitals. The Centers for Medicare & Medicaid Services (CMS) began its Increasing Organ Transplant Access model on July 1, 2025. Since July 1, 2026, participating hospitals have been eligible for additional payments or may owe payments based partly on transplant volume and organ-offer acceptance. The model does not cover intestine transplants.
