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Median MELD and PELD at transplant scores updated

Median MELD and PELD at transplant scores updated

Audience

  • Liver transplant program directors and administrators
  • Liver transplant surgeons and physicians
  • Liver transplant program clinical coordinators, data coordinators, compliance and quality managers and clinical support staff

At-a-glance

As of Sept. 24, 2019, updated median MELD at transplant (MMaT) and median PELD at transplant (MPaT) scores are being used as a basis for assigning exception scores for liver transplant candidates.

The new scores are listed here for reference.  The MMaT for one DSA has been updated from the chart originally posted Sept. 9, reflecting a change in its regional variance.

If your transplant program’s MMaT score has changed as a result of the update, exception scores indexed to the MMaT have automatically been updated for all candidates. The score also has been updated in all current requests for new or extended exception scores. You should ensure candidates’ lab tests are current in case their calculated MELD score is now more comparable to their updated exception score.

The scores are recalculated every 180 days, They are based on a 365-day cohort of transplant recipients that excludes Status 1A and Status 1B transplants, as well as transplants from living donors, cardiac death donors, and donors from outside the region of the recipient transplant hospital (national shares).

The MMaT scores are currently calculated for each liver transplant program from all transplant recipients in the cohort with a MELD score, age 12 and older at time of transplant, at all programs within the Donation Service Area (DSA) of the program listing the candidate. Please note that within your individual DSA, the MMaT may have changed to reflect differences in transplants performed within the past few months.

The MPaT score is calculated from all transplant recipients in the cohort with a PELD score, age under 12 at time of transplant. This score remains at 35 and has not changed from the previous calculation.

Resources

The updated MMaT and MPaT scores to be used effective Sept. 24 are available here.

For comparison, the scores in use prior to Sept. 24 are available here.

As reference, MMaT scores have also been updated based on liver transplants performed within a radius of 250 nautical miles of each transplant program. These scores are not currently used to assess exception scores but will be used upon implementation of liver allocation policy based on acuity circles.

Questions?

If you have questions about data or information systems, contact UNOS Customer Service at 800-978-4334. For policy-related questions, send an e-mail to [email protected].

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