Increasing equity in liver transplants
The OPTN Executive Committee has charged the OPTN Liver and Intestinal Organ Transplantation Committee to develop a liver distribution policy that does not use DSAs or OPTN Regions. Prior to that time, the OPTN Liver and Intestinal Organ Transplantation Committee will circulate a proposed liver allocation policy or policies for input in a special public comment period. The OPTN Board of Directors’ decision will be informed by public comments received, data and scientific modeling from the Scientific Registry for Transplant Recipients (SRTR), and the directives included in a HRSA letter dated July 31, 2018. HRSA is not expecting any particular policy outcome, but the OPTN Board of Directors has been directed to act on the liver allocation policy by its December 2018 meeting.
Read and comment on the proposal to revise liver and intestine distribution.
- SRTR Liver Simulated Allocation Model (LSAM) Analysis Report - (PDF - 15 MB)
- DSA-level Data Tables - Data Request Based on Circle-Based Allocation - (PDF - 136 KB)
- OPTN Liver and Intestinal Organ Transplantation Committee Data Analysis Request - (PDF - 466 KB)
- Proposed distribution frameworks overview (PDF - 1.3 M; 8/2018)
- Ad Hoc Geography Committee's charge, its members, and summaries of previous meetings.
- Article in the Journal of Health & Biomedical Law analyzing legal issues related to the emergent lung allocation policy enacted in November 2017. (PDF - 180 K; 7/2018)
- June 6 memo to members from Board President Yolanda Becker, M.D. (PDF - 51 K; 6/2018)
- June 20 update to members from Board President Yolanda Becker, M.D. (PDF - 63 K; 6/2018)
- Read a July 31 memo from HRSA Administrator George Sigounas, M.S., Ph.D., to the OPTN regarding further development of organ distribution policies. (PDF - 142 K; 7/2018)
- Read an August 13 reply from the OPTN to HRSA’s memo of July 31. (PDF - 251 K; 8/2018)
The OPTN is working to improve the equitable allocation of livers for transplantation for patients across the country waiting for a liver transplant.
The MELD score is used to assess liver candidates’ severity of illness. The OPTN is committed to developing a policy to minimize the variance in the median MELD score at transplant across different areas of the country.
The OPTN/UNOS Liver and Intestinal Organ Transplantation Committee has studied a number of possible solutions. It has widely sought public feedback on concepts to improve liver distribution and reviewed statistical modeling of the possible impact of various options.
- Learn more about how a proposal idea can become transplant policy.
- Questions? Contact us at firstname.lastname@example.org.
Watch a video about how organ allocation and distribution policy is made. [Exit Disclaimer]
Liver allocation and distribution policy has continued to evolve since it began in 1987. Changes over time have broadened urgent candidates’ access to liver transplantation and significantly reduced deaths among waiting list candidates.
Per the OPTN Final Rule, OPTN allocation policies must, among other factors, be based on sound medical judgment, seek to achieve the best use of donated organs, and shall not be based on a candidate’s place of residence or listing except to the extent required to satisfy other factors. The OPTN and transplant community must always balance these factors as organ allocation policies are created and changed.