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New expedited liver policy in effect

New expedited liver policy in effect

Effective March 25, 2021, the Organ Procurement and Transplantation Network implemented a new policy to establish a system for the expedited placement of deceased donor whole livers in the event of a late turndown by an intended candidate.

The new policy clarifies how to place these organs and provides requirements for organ procurement organizations (OPOs) and transplant hospitals when there is a need to expedite placement of deceased donor livers. It also provides a consistent process which can be practiced across the country and regulated by policy.

As a result of the new policy, OPOs must be aware that expedited liver candidates will be identified on the original liver match run. This will allow for advanced planning and communication for potential expedited offers.

Transplant hospitals have the opportunity to indicate their willingness to accept an expedited liver offer on a candidate-by-candidate basis, but in order to participate they are required to enter specific acceptance criteria in advance. They must also respond with a provisional “yes” to expedited offers within 30 minutes in order to be eligible to receive the liver for their candidate. After the 30-minute period, OPOs are required to place the liver with the candidate with a provisional “yes” that appears highest on the match run.

Previous OPTN liver allocation policy did not address the expedited placement of organs. The absence of policy language created a lack of transparency about how late turndowns are handled, and a lack of consistent guidance for OPOs and transplant hospitals. This could have ultimately affected a candidate’s access to a lifesaving liver transplant if they were bypassed on the match run.


Find more details about the changes, including professional education and monitoring information, in the policy implementation toolkit in the Professional Education section of this website.

Learn more about the implementation here.

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