Arizona woman's transplant journey highlights US organ system complexities

The experience of Katherine Screws, an Arizona resident who waited three years for an intestine transplant following a 2022 car crash, has highlighted significant variations and complexities within the United States organ transplant system.

Screws, who was reliant on intravenous nutrition after her small intestine was removed, eventually received a transplant at MedStar Georgetown University Hospital in June 2025. Before her surgery, nine organ offers for her were declined during 2024. Her case illustrates how hospital decisions regarding which organ offers to accept can significantly impact waiting times.

According to the Health Resources and Services Administration (HRSA), factors such as compatibility, medical urgency, time on a waiting list, and distance between donor and hospital influence matching. While patients may seek placement on multiple waiting lists to improve their chances, each hospital maintains its own criteria for listing patients and accepting organs. Experts note that significant variations exist between transplant centers, partly due to surgeon experience with complex organs or specific donor profiles.