Effective July 27, 2023, updated guidance is in place regarding the National Liver Review Board (NLRB) consideration of adult transplant candidates listed for any of the following organ combinations:
- Liver-intestine
- Liver-intestine-pancreas
- Liver-intestine-pancreas-kidney
- Liver- intestine-kidney
The updated guidance document establishes a new section addressing the criteria for exception scores for such candidates to reflect their unique needs relative to liver-only candidates. It recommends that candidates who qualify for an exception based on these needs be provided a score of the median MELD at transplant (MMaT) plus six points. It also recommends that every 90 days thereafter, if the candidate remains listed, the score will be increased three points.
Liver transplant program staff should familiarize themselves with the changes. They may affect candidates who may newly qualify for an exception, and/or result in changes to the exception score for eligible candidates.
