Several changes to the adult deceased donor liver allocation sequence will be implemented this summer and fall.
The national share for liver intestine candidates (approved by the Board of Directors in November 2011) and the “Share 35 Regional” and “Share 15 National” policies (approved in June, 2012) will be combined into one algorithm (see below). We expect these changes to be implemented in June or July of this year.
The revised HCC exception policy, incorporating stricter imaging criteria, is also scheduled for implementation later this year. We are planning to provide additional training opportunities for this change, so stay tuned! See OPTN Policy 3.6.4.4 for more information.
You will receive an email from UNOS Technology Implementation approximately one month before we implement each change. If you have any questions, please contact your Regional Administrator.
Combined Share 15/35/Liver-Intestine Allocation policy changes:
Adult Donor Liver Allocation Algorithm
Combined Local and Regional
1. Status 1A candidates in descending point order
2. Status 1B candidates in descending point order
Local and Regional
3. Candidates with MELD/PELD Scores >=35 in descending order of mortality risk (MELD) scores, with Local candidates ranked above Regional candidates at each level of MELD score
Local
4. Candidates with MELD/PELD Scores 29-34 in descending order of mortality risk scores (probability of candidate death)
National
5. Liver-Intestine Candidates in descending order of status and mortality risk scores (probability of candidate death)
Local
6. Candidates with MELD/PELD Scores 15-28 in descending order of mortality risk scores (probability of candidate death)
Regional
7. Candidates with MELD/PELD Scores 15-34 in descending order of mortality risk scores (probability of candidate death)
National
8. Status 1A candidates in descending point order
9. Status 1B candidates in descending point order
10. Candidates with MELD/PELD Scores >=15 in descending order of mortality risk scores (probability of candidate death)
Local
11. Candidates with MELD/PELD Scores < 15 in descending order of mortality risk scores (probability of candidate death)
Regional
12. Candidates with MELD/PELD Scores < 15 in descending order of mortality risk scores (probability of candidate death)
National
13. Candidates with MELD/PELD Scores < 15 in descending order of mortality risk scores (probability of candidate death)