Board approves new liver allocation requirements, transplantation of non-resident candidates

Published on: Wednesday, June 27, 2012

Richmond, Va. - The OPTN/UNOS Board of Directors, at its semi-annual meeting June 25 and 26, approved revisions to liver allocation policy to ensure broader access to organs for candidates in urgent need of liver transplantation. "The new sequence of liver allocation is expected to save lives by allowing more urgent candidates to receive the gift of life," said OPTN/UNOS President John Lake, M.D. "It is a continued refinement of an allocation system that has vastly reduced liver waiting list deaths over the past decade."

Liver candidates age 12 or older receive allocation priority based on the Model for End-Stage Liver Disease (MELD); candidates from newborn to age 11 are prioritized by the Pediatric End-Stage Liver Disease (PELD) model. An individual score is generated for each candidate based on objective laboratory tests. A small number of liver candidates are separately listed as a Status 1A or Status 1B and have the highest priority for transplantation.

Under the approved modifications, livers from adult deceased donors will be considered for candidates with a MELD or PELD score of 35 or higher at the local and regional level before being offered to any candidate with a lower score. In addition, livers from adult deceased donors will be offered to candidates who are listed as a Status 1A or 1B or who have a MELD or PELD score of 15 or higher at the local, regional and national levels before they are offered to any candidates of lesser urgency within the local service area of the donor hospital.

The Board also approved a series of amendments to policy regarding the transplantation of candidates who are not residents of the United States. The amendments included refined definitions for more precise data collection of resident status, as well as new processes for review of transplants involving non-resident recipients and public reporting of such transplants.

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.