Liver Allocation Policies

I did a little more research and found the actual policies governing liver allocation by OPTN (Organ Procurement and Transplantation Network).  The full policy for the Liver is located here but I’ll summarize the salient points:

As a reminder, my MELD score is currently 14 – there are a LOT of candidates that are higher on the transplant list (i.e. have a higher mortality risk).

Adult livers are allocated in the following sequence:    

At each level there is a further ordering of candidates related to mortality risk.  For example – Level 3 candidates with MELD of 40 is ahead of 39, etc.

  1. Combined Local and Regional Status 1A candidates (life expectancy less than 7 days)
  2. Combined Local and Regional Status 1B candidates
  3. Combined Local and Regional MELD Scores >=35, Local candidates ranked above Regional candidates at each level of MELD score
  4. Local Candidates with MELD Scores 29-34
  5. National Liver-Intestine Candidates
  6. Local Candidates with MELD Scores 15-28
  7. Regional Candidates with MELD Scores 15-34
  8. National Status 1A candidates (life expectancy less than 7 days)
  9. National Status 1B candidates
  10. National Candidates with MELD Scores >=15
  11. Local Candidates with MELD Scores < 15
  12. Regional Candidates with MELD Scores < 15 
  13. National Candidates with MELD Scores < 15

Adult Candidate Reassessment and Recertification Schedule

  • Status 1A and MELD Score >= 25: Every 7 days.
  • MELD Score <= 24 but > 18: Every 1 month.
  • MELD Score <= 18 but >=11: Every 3 months.
  • MELD Score <= 10 but > 0 Every 12 months.

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