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Access for urgent liver candidates in Hawaii and Puerto Rico to be implemented Feb. 18

Access for urgent liver candidates in Hawaii and Puerto Rico to be implemented Feb. 18


Liver and intestine transplant program directors, surgeons, physicians, administrators, clinical coordinators, data coordinators and clinical support staff; OPO executive directors and procurement directors/managers; compliance and quality managers

Implementation date: Feb.18, 2020


On Tuesday, Feb. 18, a variance will be implemented to improve timely access to donors for candidates listed as Status 1A, Status 1B, or with a MELD or PELD score of 37 or higher in Hawaii and Puerto Rico. It will establish additional geographic units of 1,100 nautical miles for candidates listed in Puerto Rico and 2,400 nautical miles for candidates listed in Hawaii. Details of the policy are contained in this policy notice.

The UNOS Secure EnterpriseSM system, which includes UNetSM and other transplant applications such as WaitlistSM, DonorNet®, TIEDI® and KPDSM, will be unavailable for a brief period of time the morning of Feb. 18, beginning at 7 a.m. Eastern standard time, to allow for implementation.

Implementation details

These additional distribution units will only apply for candidates listed in Hawaii or Puerto Rico who are in urgent need of a liver transplant.  The additional classification will follow other distribution sequences in the acuity circle liver policy for urgent candidates listed at transplant hospitals within a radius of 500 nautical miles of the donor hospital.  The additional classifications will not apply to any candidates in Hawaii or Puerto Rico with a MELD or PELD score below 37.

The variance will be evaluated annually and will expire after five years. It may be more likely to affect OPOs in areas geographically closest to the transplant programs in Hawaii or Puerto Rico, although the overall number of candidates expected to be affected by the variance is expected to be low.

What you need to do

As of the implementation date, match runs for liver and liver-intestine offers will follow the new sequence.  Continue to follow the match run process as usual

Resources and education

Access policy and system training in UNOS Connect from the course catalog; Liver category

  • LIV101-D: Access for Urgent Liver Candidates in Hawaii and Puerto Rico

If you have questions relating to implementation, contact UNOS Customer Service at 800-978-4334.  For policy-related questions, send an e-mail to [email protected].

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