@luigirovatti I don’t know if you’re in America, but this is what little I know about it in America.
Organ coordinators fly organs all over the country as mentioned above. When you need an organ you go into a national database.
There is such a thing as specifically naming someone to receive an organ if you are doing a live donation, maybe even in death for some organs, that I don’t know about specifically, but a good amount of donations for organs are unplanned deaths, and their organs go to the next person on the list who is a match, and the organ can arrive in time. Big storm in the area that a flight can’t take off in literally can mean a person can’t get an organ from a faraway state that if weather was good they could have had it. Usually, this is avoided by keeping the “dead” person on life support, but unpredictable things happen. All these details are monitored to ensure a transplant will be successful.
People can move up the list depending on urgency, but you have to qualify and meet the standards.
There is judgement used on who is most likely to benefit from the organ, it is like playing God in a way. That’s how it works. The government regulates it to some extent, and the United Network of Organ Sharing (UNOS) and serious ethical questions are scrutinized regarding who gets priority on the list.
Most liver failure happens over time, although there is such a thing as very rapid, acute, liver failure.
If a person’s liver function is going down, and the person is an alcoholic, and wants the option of a liver transplant, it’s time to stop drinking. If they stop, they might never need the transplant, even better.
There is no way to make it completely fair. There aren’t enough livers for everyone who needs one.
I used to know an organ coordinator, and he was constantly flying organs to different cities and states. Mostly kidneys.