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Improvements to MELD and PELD: Phase 1 (data entry) in effect June 15

Improvements to MELD and PELD: Phase 1 (data entry) in effect June 15

Sample calculators to be updated; webinars planned in June

Effective June 15, 2023, new and updated data fields will be available to support the full implementation of improvements to MELD, PELD, Status 1A and Status 1B. The policy will be fully implemented as a separate Phase 2 on Thursday, July 13, 2023.

During Phase 1, the sample MELD and PELD calculators on the OPTN website will show two different outputs on the OPTN website. One view will display a score based on the new policies in effect July 13. The other view will show a score based on the current calculation in place until then.

Beginning June 15, liver transplant programs may enter or edit values to support the new calculations. Data reporting for these fields is not required until the Phase 2 implementation in July, but advance data entry will ease the transition to the new policy. The program may need to update lab tests or get additional information from the transplant candidate to ensure it has the most current and complete information.

The OPTN will provide candidate-level reports in the UNetSM Data Services Portal to help transplant programs identify candidates with missing data prior to implementation of Phase 2. The OPTN will also provide additional notice and information in advance of Phase 2 implementation.

From June 15 until implementation of Phase 2, the MELD and PELD sample calculators will show, in separate tabs, scores generated by the current calculation as well as by the updated calculation that will be in place beginning July 13. You may compare the two calculations to see the effect the new policy may have on an individual’s MELD or PELD score.

Updated and new data fields

  • For all current transplant candidates of any organ type, as of June 15, the data field currently titled “gender” in all TIEDI® forms will be titled “birth sex.” This will be an automatic update of the field title and will not affect the data currently entered for any candidate.
  • A new field, “Sex for Purposes of Adult MELD Calculation,” will be deployed for all adult liver candidates (age 18 or older at the time of registration). This field will be required for all adult candidates registered after implementation of Phase 1. The field will be optional and may be edited for adult candidates already on the OPTN Waiting List, if the candidate’s “Sex for Purposes of Adult MELD Calculation” is different than their birth sex.
  • As of July 13, an albumin value will be required for all MELD candidates. (This is already a data requirement for PELD candidates.)
  • As of July 13, a creatinine value will be required for all PELD candidates. (This is already a data requirement for candidates age 10 or older.)

Note: While Phase 2 of the policy will also include some updates to classification of pediatric candidates in Status 1A or Status 1B, these changes do not require new or updated data entry.

June webinars; additional informational and educational resources coming soon

The OPTN Liver and Intestinal Organ Transplantation Committee and Pediatric Transplantation Committee have scheduled two webinars to help transplant programs understand and prepare for the upcoming policy changes. While both webinars will have some common background information, the first session will emphasize Phase 1 implementation and the second will focus more on Phase 2. The dates and registration links are below.

In addition, the committees will host an additional webinar to address questions from liver transplant candidates and their families. The date and registration link are below.

The OPTN is preparing a series of frequently asked question (FAQ) documents, as well as a guide to calculating the updated MELD and PELD scores. These documents will be posted as soon as available on a new section within the Liver and Intestine professional resources page on the OPTN website. In addition, an educational offering will be added soon to UNOS Connect, the OPTN’s learning management system. Additional updates will be provided as these resources become available.

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