The OPTN/UNOS Liver and Intestinal Organ Transplantation Committee continues work on various initiatives intended to promote equitable organ allocation and distribution, consistent with the OPTN final rule. The following summary addresses committee actions as of June 2017.
National Liver Review Board approved
The OPTN/UNOS Board of Directors approved proposals to establish a National Liver Review Board (NLRB), which would replace the individual review boards in each region. The NLRB is anticipated to be implemented in 2018, pending system programming and recruitment/orientation of review board members.
The committee continues to develop a detailed monitoring plan for the NLRB that will look for any potential unanticipated and unwanted consequences. Should any significant concerns arise through such monitoring, the committee will address them in policy as early and thoroughly as possible.
Liver distribution status update
The committee has developed and will seek public comment on a new proposal to address geographic disparities in liver candidates’ MELD at transplant, while minimizing unwanted consequences such as increased travel distance for liver offers. Public comment is set to begin July 31 and end October 2.
The new proposal would not redraw existing regional boundaries. It would, however, provide additional transplant access to candidates at a greater medical priority level who are listed at hospitals within 150 nautical miles of the donor hospital, even if the donor and transplant hospital are in different regions. This would allow urgent candidates who are relatively close to the donor hospital but in a different region to have earlier access to available livers.
The public comment proposal will contain additional details, and additional simulation modeling results for this concept will be made public as soon as they are available.
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