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Split liver variance

Proposal Overview

The comment period for this proposal is now closed.

Sponsoring Committee: Liver and Intestinal Organ Transplantation

Strategic Goal: Increase the number of transplants

Read the modified proposal (PDF; 12/2019)

View the policy notice (PDF; 691 K; 6/2019)

View the Board report (PDF - 538 K; 6/2019)

Read the proposal (PDF; 1/2019)

Contact: Elizabeth Miller

Executive summary

This proposal would create a variance to permit participating liver programs to split a liver and transplant the first segment into the candidate to whom it was allocated, and then transplant the remaining segment into another candidate at the same transplant hospital or an affiliated hospital after offering the remaining segment to the most urgent candidates within 500 nautical miles. The goal is to increase the number of livers that are split and thereby increase the number of liver transplants available from the same donor pool. It aims to reduce the logistical and technical challenges currently associated with splitting a liver. The variance would be used to determine whether it would in fact increase the number of transplants by increasing the number of livers that are split.

This variance was initially proposed by transplant hospitals and OPOs in region eight, who requested it as a regional variance. However, transplant hospitals in other regions expressed interest, and the Committee proposes that this be an open variance that other OPTN members can also join.

Feedback requested

The Committee encourages all interested individuals to comment on the proposal in its entirety. Members are asked to comment on both the immediate and long-term impact on budgets and other resources that may be required if this proposal is approved; this information assists the Board in considering the proposal and its impact on the community. The Committee requests specific feedback on the following items:

  1. Members are asked to comment on whether this variance should only be available to region eight, or if it should be available to other OPTN members that would like to participate.
  2. Members are also asked to comment on whether they would be interested in participating in this variance so that the Committee can gauge the level of interest in the variance.