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Now in effect: Changes to liver-kidney nautical mile threshold

Now in effect: Changes to liver-kidney nautical mile threshold

Implementation date

Sept. 28, 2023


The required share threshold for simultaneous liver-kidney (SLK) allocation has expanded from 250 nautical miles to 500 nautical miles for eligible adult candidates (e.g., Status 1A or MELD of 29 or greater).

This only impacts adult candidates, medical eligibility diagnosis requirements for simultaneous liver-kidney transplant candidates has not changed.

This policy does not impact pediatric simultaneous liver-kidney patients, who do not fall under any nautical mile allocation threshold.

What you need to do

OPOs will now see “RQ” for required share displayed in match classifications up to 500 nautical miles and should offer kidneys along with the liver accordingly.

Transplant centers do not need to take any action on behalf of their patients. Eligible SLK candidates within the new 500 nautical mile threshold will now display as a required share (“RQ”) on the liver match run when they are listed as Status 1A or have a MELD of 29 or greater.

Education and resources

Educational offerings are available in UNOS Connect, the OPTN’s learning management system. The course numbers and titles are:

  • ORG100: Allocation of Multi-Organ Combinations
  • LIV103: Simultaneous Liver Kidney Allocation Policy

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].

The Organ Center is available 24 hours a day at 800-292-9537.

View the UNetSM System Status page

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