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Three-month monitoring report for updated liver urgency policy shows progress

Published on: Tuesday, June 4, 2024

A data report is available detailing the first three months of liver allocation policy after updates were implemented to improve candidate priority based on medical urgency scores. A key intended policy outcome is to increase parity in access to liver transplant among adult male and female candidates. While the three-month interval is a very preliminary monitoring period, the report indicates progress toward this objective.

Key observations, comparing three months of outcomes before and after the updates took effect, include the following:

  • For MELD candidates (aged 12 and older), both the number and rate of liver transplants increased after policy implementation. There were 2,125 deceased donor liver transplants in the pre-policy era, increasing to 2,163 post-policy.
  • The rate and number of transplants for female MELD candidates increased significantly from the pre- to post-policy timeframe, while the number and rate for male MELD candidates remained roughly the same before and after policy implementation. The number of deceased donor liver transplants for female recipients increased from 730 in the three months prior to the policy change to 867 in the first three months after the policy took effect.
  • There were no statistically significant changes in the rate of MELD candidates removed from the waiting list due to death or being too sick to transplant.
  • For PELD candidates (aged 11 years and younger), there were no statistically significant changes either in transplant rate or the rate of waiting list removal due to death or being too sick to transplant.
  • The number of pediatric Status 1A and 1B liver transplants decreased from the pre-policy to post-policy era. Recipients with chronic liver disease made up the largest proportion of pediatric Status 1A and 1B recipients.
  • The number of pediatric Status 1B cases that qualified by exception (meaning they did not meet standard qualification criteria) decreased from the pre-policy to post-policy timeframe.

The OPTN Liver and Intestinal Organ Transplantation Committee will continue to monitor policy effects, with the next planned report for the six-month period after policy implementation.