Liver policy updates
Liver policy to revert to DSA-based system due to court order
May 17, 2019 – The Health Resources and Services Administration (HRSA) has instructed UNOS, as the OPTN contractor, to revert to the liver distribution policy in place prior to May 14, 2019, utilizing boundaries based on donation service areas and regions, consistent with a federal court order. For further information, refer to a HRSA letter to UNOS and UNOS’ reply to HRSA on May 17, 2019.
In all instances, organ procurement organizations and liver transplant programs should continue to follow the match run generated in UNetSM for liver donors and potential recipients.
We understand that these events are unfolding rapidly. We will continue to keep you informed of new developments.
Court order cease and desist on further liver policy implementation
May 15, 2019 – UNOS received an Order from a federal court in Atlanta not to do further work implementing the new liver allocation policy approved by the OPTN Board of Directors in December 2018. As the policy has already been implemented, we are seeking clarification from the judge. In the meantime, OPOs and transplant centers should follow the match runs that UNet generates. If we make changes to UNet, we will notify the community.
Liver policy changes and National Liver Review Board in place
May 14, 2019 – Today, a federal court in Atlanta denied a request to delay implementation of the liver distribution policy approved by the OPTN Board of Directors in December 2018. The plaintiffs have indicated an intent to appeal that ruling and as of this message, no injunction has been ordered that would further delay implementation of the policy. As a result, the new policy will go into effect on May 14. Implementation of the National Liver Review Board (NLRB) will also go into effect on the same date, and the planned conversion of exception scores for most candidates who have current exceptions will take place at that time.The transplant community, including a committee comprising transplant experts, organ recipients, and donor families from around the country and the OPTN Board of Directors—with extensive input from the public—came together to develop and approve the new policy.Simulation modeling of the new policy suggests it will be fairer to patients nationwide, save more lives by reducing pre-transplant deaths, and improve transplant access for children in need of a transplant. Additional details about the policy are available on the liver distribution page on the UNOS website.