Align units of distribution in closed variance for split liver transplantation
Sponsoring Committee: Liver and Intestinal Organ Transplantation
Strategic Goal: Increase the number of transplants
Read the policy notice (PDF; 12/2019)
View the Board Briefing Paper (11/2019)
Read the proposal (PDF; 10/2019)
Read the proposal that passed the underlying variance (PDF; 6/2019)
Contact: Elizabeth Miller
The OPTN Board of Directors (the Board) approved a new closed variance for the allocation of the second segment of split livers on June 10, 2019. The variance permits participating transplant programs to offer the second segment of the split liver to a candidate at the same transplant program or an affiliated transplant program once the segment has been offered to candidates with a model for end-stage liver disease (MELD) or pediatric end-stage liver disease (PELD) score of at least 33 and Status 1 candidates listed at liver transplant programs within 500 nautical miles (NM) of the donor hospital.
Under the proposed changes, the second segment of the liver would be offered to transplant programs within the same region as the donor hospital, rather than within 500 NM and with a MELD or PELD of at least 35 instead of at least 33. The resolution will also allow these changes to automatically revert to 500 NM and MELD or PELD of 33 upon implementation of the Acuity Circles policy. The proposed changes would allow the units of distribution used in the variance to align with the units of distribution used in the allocation of deceased donor livers.