In June 2009 the OPTN/UNOS Board of Directors approved standardized criteria and MELD/PELD exception scores for patients with the following diagnoses:
- hepatopulmonary syndrome
- cystic fibrosis
- familial amyloidosis
- primary hyperoxalruia
- portopulmonary hypertension
Clinical personnel at transplant centers can now enter these scores for their patients into UNETSM. The software application in UNETSM, however, cannot automatically review and approve these exceptions, so some sort of human review is still necessary.
The liver committee modified the Regional Review Board (RRB) Guidelines to allow the RRB chairs to determine on their own if the standardized cases meet the criteria in policy, without forwarding it to the entire review board. RRB chairs will review the information that you submit. If the case meets the stated criteria, the chair will mark it as approved. If not, UNOS staff will submit it to the entire review board.
To make it easiser for you to submit exception cases to the RRB chair, the liver committee developed standard templates for each diagnoses. Follow these directions and use these templates when you enter required information into the MELD/PELD exception application.