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Expedited Liver Placement policy implementation begins March 25, 2021

Expedited Liver Placement policy implementation begins March 25, 2021


  • Organ Procurement Organizations
    • Primary OPO Administrative Directors, Primary Data Coordinators, Organ Procurement Adms/Mgrs, Regulatory Affairs Coordinators/Managers, Compliance Officers, Data Coordinators, OPO Quality Managers/Coordinators, Quality Coordinators, Quality Directors/Managers, Organ Placement Coordinators, Organ Procurement Coordinators, Organ Procurement Adms/Mgrs
  • Transplant Hospitals
    • Liver Primary Program Administrators, Primary Data Coordinators, Primary Physicians, Primary Surgeons, Liver TX Program Administrators/Managers, TX Program Directors, TX Program Medical Directors, Clinical Training Coordinators/Managers, TX Program – Clinical Coordinators, Support Staff-Clinical, Data Coordinators, Regulatory Affairs Coordinators/Managers, Compliance Officers, Quality Directors/Managers, Quality Coordinators, TX Program Surgical Directors, TX Surgeons

Implementation date

March 25, 2021


To clarify expedited placement surrounding deceased donor whole livers, this release aims to give clarity on how to place these organs when late turndowns occur and provides guidance for organ procurement organizations (OPOs) and transplant hospitals (TXC) when there is a need to utilize expedited placement. It also provides a consistent process which can be practiced across the country and regulated by policy.  All associated policies will be implemented March 25, 2021.

What you need to do 

  • OPOs
    • Will need to prepare staff to begin utilizing the expedited liver placement process. See the Education and Resources section below to aid in this training.
    • Upon release, will need to start deciding when to initiate expedited placement on deceased donor livers when appropriate according to associated policy 9.10.B.
    • Will need to report data to the OPTN, within the workflow wizard in accordance with policy 9.10.B, prior to sending expedited liver offers.
    • Will need to enforce the new 30-minute evaluation time limit for expedited offers by applying a bypass to the transplant centers that have exceeded this time limit.
  • TXCs
    • Will need to continue updating Contact Management in DonorNet® with on call contacts to receive expedited organ offer notifications. See previous system notice.
    • Will need to continue evaluating liver candidates on a candidate-by-candidate basis to receive expedited liver organ offers. See previous system notice.
    • Will need to begin managing expedited organ offer notifications. This includes adhering to the new 30-minute evaluation time limit for expedited offers received.
    • See previous system notice for more details on the above TXC details.

Additional details

Phase 1 implementation was released Feb. 25, 2021, and was intended to give the transplant hospitals one month to complete the tasks listed in the previous notice.  This release, Phase 2, is the final release for this implementation and will give the OPOs the tools they need to be initiating expedited liver offers.  Both the OPO staff and TXC staff should be prepared to utilize these tools and respond to these offers respectively.

Education and resources

  • The following training materials are available in UNOS Connect and accessible to UNetSM users through the resources tab on the Secure Enterprise (UNet) homepage:
    • SYS106-D: Opting in for Expedited Liver Offers
    • SYS164: Expedited Liver Placement for OPOs and TXCs – available March 8, 2021
    • System-related FAQ is attached as a resource to both courses above as well as in the DonorNet Online Help
  • OPTN policy notice: Expedited Liver Placement
  • Online help documentation covering UNet functionality will be available when the system updates go into effect. Access Secure Enterprise and then choose either WaitlistSM or DonorNet. On the Help menu, click Online Help. You may search for a specific help topic or use the table of contents to assist with your search.
  • A resource toolkit is available on the OPTN website.

Additional OPO education and resources

To help you prepare for the release of expedited liver placement in March, we would like you to have an opportunity to log into a test version of the system to preview the new expedited liver placement tools.

The test site will be available from Tuesday, March 9 through Friday, March 12, and will be populated with blinded test data.  If you are interested in participating in this opportunity, please email the IT Project Lead, Darby Harris ([email protected]), and provide a primary contact name, phone number and email address.

The deadline for submitting your OPO as a participant is Friday, March 5.  Login information and detailed instruction will be provided to your named contact on Monday, March 8. This test site will not be available after March 12.


If you have questions relating to implementation, contact UNOS Customer Service at [email protected], or call 800-978-4334 from 8 a.m. to 7 p.m. ET.

For policy-related questions, contact [email protected].


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