Background: Prolonged cold ischemia time (CIT) is associated with worse outcomes after deceased donor liver transplant. One factor influencing CIT is transport time, the time it takes to transport an organ from the donor hospital to the transplant center. Distance from donor hospital to transplant center is often employed as a surrogate for transport time.

Methods: We geolocated all donor hospitals and transplant centers for adult deceased donor liver transplants in 2010. We estimated transport time between each donor hospital and each transplant center by four different modes: driving, helicopter, turboprop, and jet. Driving times were estimated by Google. Times for turboprop and jet transports included drive times between hospitals and airports. We surveyed organ procurement organizations to determine whether they use helicopters for liver transports. We estimated transport time by a decision tree among the four travel modes.

Results: Distance is an imperfect proxy for transport time, particularly in the range of 50-100 miles of transport distance, because of the availability of different travel modes. CIT is highly variable but is lower-bounded by transport time and averages five hours greater than transport time.

Conclusions: Geographically detailed transport time models incorporate specific features of hospital locations: speed limits, bodies of water, nearby versus remote airport access, et cetera, to estimate transport delays for deceased donor organs. Our model can be used to evaluate how changes in organ allocation would impact transport time, and indirectly CIT.

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