Liver & intestine
Current policy & guidance
- Evaluation plan guidance for policy 9 (7/2021)
- Liver review board guidance (07/2023)
Updates to MELD, PELD and Status 1A/1B
- Patient questions and answers for updates to MELD and PELD New
- Improving liver allocation general implementation FAQ
- Improving liver allocation MELD 3.0 FAQ
- Improving liver allocation pediatric FAQ
- Improving MELD, PELD and status 1A/1B: FAQs for patients and caregivers
- MELD and PELD calculators user guide
Implementation Overview: Improving Liver Allocation
- Six-month monitoring report: MELD 3.0 and PELD-CR (PDF 8/2024)
- Three-month monitoring report: MELD 3.0 and PELD-CR (PDF 4/2024)
Acuity circles allocation policy
The liver allocation policy makes matches by comparing medical and logistical characteristics about deceased donors and transplant candidates. In general, the first matches will be made for the most urgent candidates listed at transplant programs within a certain distance from the donor hospital. The specific sequence used will vary according to certain facts about the donor, such as the donor’s age and mechanism of death.
View examples that illustrate the allocation sequence based on different donor characteristics.
- New policy establishes expedited placement of livers (3/25/2021)
- New national liver and intestinal organ transplant system in effect (2/4/2020)
- Updated liver and intestinal organ allocation policy implemented Feb. 4, 2020 (1/18/2020)
- Assessing liver transplant candidates' level of illness (8/21/2019)
- Liver allocation policy reverted to DSA and regions (5/23/2019)
- Work in progress to revert to DSA-based system due to court order (5/20/2019)
- New national liver transplant system takes effect (5/14/2019)
- Liver distribution policy, national liver review board, deferred until May 14 (4/23/2019)
- Board approves updated liver distribution system (12/2018)
- Two Year Monitoring Report of Liver and Intestine Acuity Circle Allocation Removal of DSA and Region as Units of Allocation (8/5/2022)
- Expedited liver placement pathway six-month post policy Implementation Monitoring Report (12/8/2021)
- Eighteen-month monitoring report available for removal of DSA and region as units of allocation (12/3/2021)
- Fifteen-month monitoring report available for removal of DSA and region as units of allocation (8/9/2021)
- One-year monitoring report available for removal of DSA and region as units of allocation (4/5/2021)
- Nine-month monitoring report available for removal of DSA and region as units of allocation (2/1/2021)
- Six-month monitoring report available for removal of DSA and region as units of allocation (10/18/2020)
- Two-month monitoring report available for removal of DSA and region as units of allocation (4/27/2020)
National Liver Review Board (NLRB)
Current scores
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 09/2024)
Previous scores
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 03/2024)
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 09/2023)
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 03/2023)
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 09/2022)
- Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF: 06/2022)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF: 03/2022)
- MTS comparison (03/2022)
- Updated monitoring report available for liver, intestine policy (PDF; 9/2021)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF; 10/2021)
- MTS comparison (10/2021)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF: 03/2021)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF: 9/2020)
- Median MELD at Transplant by circles reference effective March 25, 2020 (PDF: 3/9/2020)
- Frequently Asked Questions: Calculate Median MELD at Transplant (MMaT) around the Donor Hospital and Update Sorting within Liver Allocation (PDF: 06/2022)
- NLRB educational webinar (2/2020)
- NLRB update (10/2019)
- NLRB webinar presentation (PDF: 10/2019)
- NLRB for members (4/2019)
- NLRB for review board members (4/2019)
- Updated median MELD at transplant scores in effect; revisions made to MMaT and MPaT scores (10/14/2022)
- Two-year monitoring report summarizes National Liver Review Board activity (7/25/2022)
- Report lists median MELD at transplant score for each donor hospital (6/23/2022)
- Educational webinar addresses NLRB process (10/1/2019)
- National liver review board is implemented (5/14/2019)
- National Liver Review Board Two Year Post-Acuity Implementation Report (PDF 7/2022)
- Updated 18-month monitoring report available for National Liver Review Board (3/16/2022)
- Updated monitoring report now available for liver, intestine policy (12/14/2021)
- Updated monitoring report available for liver, intestine policy (9/15/2021)
- Updated 12-month monitoring report available for National Liver Review Board (5/12/2021)
- Updated 9-month monitoring report available for liver policy (1/15/2020)
Allocation calculators
The Model for End-Stage Liver Disease (MELD) and Pediatric End-Stage Liver Disease (PELD) calculators are numerical scales used for liver allocation.
MELD calculator
Ages 12 and older PELD calculator
Under age 12