System notice: Clarification of pre-existing liver disease implemented March 1

System notice: Clarification of pre-existing liver disease implemented March 1


Liver transplant program directors, surgeons, physicians, administrators, clinical coordinators, compliance and quality managers

Implementation date:

March 1, 2020


On Sunday, March 1, 2020, clarifications were made to policy requirements for adult and pediatric Status 1A listing. The updated language clarifies that a candidate diagnosed with liver disease prior to a previous liver transplant can qualify as a Status 1A for re-transplantation due to fulminant liver failure, provided that the candidate is not diagnosed with liver disease following the initial transplant. The goal of the clarification is to ensure that candidates for re-transplant who are experiencing fulminant hepatic failure receive the same access to organ transplant as other similar candidates with fulminant hepatic failure.

Details of the policy are contained in this policy notice.

What you need to do

Please familiarize yourself and your clinical staff with the clarified qualifications for candidate listing. While this is an important clarification, it is expected to apply in only a rare number of instances.

These updates do not change any details relating to the sequence of matches for candidates or to the OPTN Member Evaluation Plan.

If you have questions relating to implementation, contact UNOS Customer Service at 800-978-4334.  For policy-related questions, send an e-mail to or call 844-395-4428.

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