News reports surrounding the death of former Microsoft co-founder Steve Jobs revealed that he underwent a liver transplant two months ago. According to a CNN report, “Livers are a scarce resource. In any given year, only about one-third of the people on the national transplant waiting list receive one, and as of late June, more than 16,000 people were on the list.

Yet it sometimes seems that celebrities in need end up at the front of the line when they need a transplant, and people often assume they get preferential treatment. (Rumors about special treatment circulated after baseball player Mickey Mantle’s liver transplant in 1995, for example.) The real gift of life: How medical donations help.

The truth is more complicated. No one can actually buy an organ in the United States (legally, that is). But getting a liver transplant, it turns out, is a lot like getting into college. Once you’re on the waiting list, your chances of getting off it depend largely on your personal circumstances — how sick you are and whether you are a good donor match. But getting on the list in the first place — or on more than one list, as the case may be — requires resources and know-how that most people don’t have.

Can some people ‘cut the line’?

There are 127 centers in the U.S. that perform liver transplants. If you need an organ transplant, your doctor will refer you to one of these centers, where you will be evaluated, given a score based on the severity of illness, and placed on the center’s waiting list, if you are indeed a candidate for transplant.

The center’s waiting list feeds into a national database managed by the United Network for Organ Sharing (UNOS), a nonprofit organization that contracts with the federal government to manage the nation’s organ transplant system.”

A Somewhat Similar Local Story


Richard DeVos, the founder of Grand Rapids based Amway Corp. and one of the country’s richest men, received a heart transplant operation at the age of 71.  DeVos owns the Orlando Magic basketball team and is listed at #60 on Forbes Magazine Richest Americans, estimating his wealth at $5 billion.

According to a 1997 Detroit Free Press article, “DeVos waited five months for his new heart — half the average time a person in Michigan waits for a heart transplant. He went to London after checking out his U.S. options and concluding that ‘his chance of qualifying for a heart transplant in the United States was about zero,’ said a close associate. The associate asked not to be named, citing the DeVos family’s preference for privacy in the last year as word grew that DeVos was seeking out medical centers worldwide that specialized in heart transplants.

‘Money didn’t buy him a heart in America,’ the associate said. DeVos had ssembled a medical team, headed by his Grand Rapids cardiologist, Dr. Luis Tomatis, to check out options for a heart transplant, here and abroad. ‘The strong conclusion was that London was his best chance,’ the associate said.

‘It is unusual for a 71-year-old man to be placed on the heart transplant list in the United States,’ said Dr. Keith Aaronson, associate professor of internal medicine at the University of Michigan Medical Center.

Non-U.S. citizens are eligible for U.S. organs, but UNOS, the monitoring agency, limits a center’s procedures for nonresidents to no more than 5 percent. In the United States, money only gets people so far. They can be listed at more than one U.S. transplant program per region, but must be evaluated by each program. Transplant surgery costs $122,601, according to one 1994 study. But costs may be double that if a person is hospitalized prior to surgery.

Wealthy people may travel around the country looking for centers to take them, Aaronson said. ‘That’s the extent, in the U.S., that money would do anything for you. But you can’t buy a heart. If you try and corrupt the system, you’d have to corrupt a whole lot of people.’”