Implementation toolkit
News
- New policy establishes expedited placement of livers (3/25/2021)
- Updated 9-month monitoring report available for liver policy (1/15/2020)
- Two-month monitoring report available for acuity circles liver distribution (5/26/2020)
- Median MELD and PELD at transplant scores to be updated March 25 (3/9/2020)
- 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)
- Public comment sought; Liver access for urgent candidates in Hawaii and Puerto Rico (11/28/2019)
- Report studies first 12 weeks of NLRB activity (10/21/2019)
- Public comment sought on split liver variance (10/8/2019)
- Educational webinar addresses NLRB process (10/1/2019)
- Assessing liver transplant candidates' level of illness (8/21/2019)
- NLRB update: Median MELD at Transplant now based on transplant hospital DSA (5/24/2019)
- Liver allocation policy reverted to DSA and regions (5/23/2019)
- Pre-implementation notice: OPTN liver allocation policy to revert to DSA and regions May 23, 2019 (5/20/2019)
- Work in progress to revert to DSA-based system due to court order (5/20/2019)
- National liver review board is implemented (5/14/2019)
- 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)
Webinar recordings
- 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)
Policy changes
Documents
- One-Year Monitoring Report of Liver and Intestine Acuity Circle Allocation Removal of DSA and Region as Units of Allocation (PDF; 04/2021)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF; 03/2021)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, Nine month report - Removal of DSA and Region as Units of Allocation (PDF; 12/2020)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, Six month report - Removal of DSA and Region as Units of Allocation (PDF; 10/2020)
- Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF; 9/2020)
- National Liver Review Board Post-Acuity Implementation Report, Three Month Data (PDF; 7/2020)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, Three Month Data (PDF; 7/2020)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, Two Month Data (PDF; 5/2020)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, One Month Data (PDF; 3/2020)
- Liver & Intestine Acuity Circle Allocation Out-of-the-Gate Report, One Month Data – Additional DSA Stratifications (PDF; 3/2020)
- Median MELD at Transplant by circles reference effective March 25, 2020 (PDF; 3/9/2020)
- Liver variance list (PDF; 3/1/2020)
- Acuity Circles FAQ (PDF; 2/18/2020)
- National Liver Review Board Out-of-the-Gate Report, Four Months Data Report (PDF; 10/2019)
- National Liver Review Board Out-of-the-Gate Report - Appendix (PDF; 10/2019)
- NLRB six-week report (PDF; 7/2019)
- Questions and answers for patients about liver allocation
- NLRB patient FAQ (PDF; 6/2019)
- View proposed liver allocation distribution dashboard
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)
Current policy & guidance
- OPTN Policy 9: Allocation of livers and liver-intestines (PDF - 2.5 MB)
- Liver review board guidance (6/2017)
- Increasing utilization of deceased donor livers (PDF - 2.5 M; 6/2012)