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Updated NLRB exception requirements effective Oct. 7

Updated NLRB exception requirements effective Oct. 7

The OPTN implemented several enhancements to the National Liver Review Board (NLRB) on October 7, 2021. The OPTN Board of Directors approved some of these actions at its December 2020 meeting and another at its June 2021 meeting. These actions include:

  • Updated criteria for initial or extension standardized exception requests for candidates with portopulmonary hypertension
  • A new Appeals Review Team to address second appeals of exception requests for pediatric candidates
  • Procedural changes to NLRB operations to increase consistency between the NLRB and the National Heart Review Board (NHRB)
  • Updated qualifications for a standardized exception for liver transplant candidates with cholangiocarcinoma

For more detail, refer to the policy notices for the enhancements approved in December 2020 and June 2021, respectively.

An additional provision approved in December 2020 addressed improvements to the review of post-transplant explant pathology forms for candidates with hepatocellular carcinoma. This provision is subject to approval by the federal Office of Management and Budget prior to implementation and is not part of the October 7 release. Liver transplant programs will be notified when this provision is set for implementation.

Liver transplant programs should be aware of the new features and requirements, as they may affect the qualifications for exception scores for some  transplant candidates. For the updated criteria regarding candidates with portoplumonary hypertension or cholangiocarcinoma, new data fields have been added to the exception request form.

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