Nationally, there are over 18,700 patients waiting for a liver transplant.

Policy 3.6 Organ Distribution

3.6 Allocation of Livers. Unless otherwise approved according to Policies 3.1.7 (Local and Alternative Local Unit), 3.1.8 (Sharing Arrangement and Sharing Agreement), 3.1.9 (Alternate Point Assignments (Variances)), and Policy 3.4.6 (Application, Review, Dissolution and Modification Processes for Alternative Organ Distribution or Allocation Systems), the allocation of livers according to the following point system is mandatory first locally, then regionally, and then nationally. Each patient will be assigned a status code corresponding to the degree of medical urgency as described in Policy 3.6.4 below. Each patient also will be assigned points for conditions as described in Policies 3.3.5, 3.6.2, 3.6.3, and 3.6.4.

Livers will be offered for patients with an assigned Status of 1 in descending point sequence with the patient having the highest number of points receiving the highest priority before being offered for patients listed in other status categories. Following Status 1, livers will be offered for patients with an assigned Status of 2A in descending point sequence with the patient having the highest number of points receiving the highest priority before being offered for patients listed in less urgent statuses.

Following Status 2A, livers will be offered for patients with an assigned status of 2B in descending point sequence with the patient having the highest number of points receiving the highest priority. Following Status 2B, livers will be offered for patients with an assigned status of 3 in descending point sequence with the patient having the highest number of points receiving the highest priority. Livers will not be offered to patients with a status of 7. Adult livers (i.e., greater than or equal to 18 years old) will be allocated in the following sequence (adult donor liver allocation algorithm):

Adult Donor Liver Allocation Algorithm

Local 1. Status 1 patients in descending point order

Regional 2. Status 1 patients in descending point order

Local 3. Status 2A patients in descending point order 4. Status 2B patients in descending point order 5. Status 3 patients in descending point order

Regional 6. Status 2A patients in descending point order 7. Status 2B patients in descending point order 8. Status 3 patients in descending point order

National 9. Status 1 patients in descending point order 10. Status 2A patients in descending point order 11. Status 2B patients in descending point order 12. Status 3 patients in descending point order