Organ Procurement and Transplantation Network

Implementation toolkit

The OPTN has reverted back to the pre-May 14th, 2019, liver allocation system based on donation service areas and regions, and Median MELD at Transplant is now based on hospital DSA. Programming has been completed. For further information, please contact member.questions@unos.org.

News

• 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)
• Work in progress to revert to DSA-based system due to court order (5/2019)
• National liver review board is implemented (5/2019)
• New national liver transplant system takes effect (5/2019)
• Liver distribution policy, national liver review board, deferred until May 14 (4/2019)
• Board approves updated liver distribution system (12/2018)

Webinar recordings

• NLRB for members (4/2019)
• NLRB for review board members (4/2019)
  

Policy changes

• NLRB- and liver distribution-related policy notices
  

Documents

• Median MELD at Transplant by DSA (PDF; 3/2019)
• NLRB operational guidelines (PDF; 1/2019)
  
• Median MELD  circles reference (PDF; 4/2019)
• For patients
  
  • Sample letter for candidates with exception scores (PDF; 4/2019)
  • Questions and answers for patients about liver allocation

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)