Revised OPTN Liver Transplantation Policy

On December 3, 2018, the U.S. D.H.H.S. Organ Procurement & Transplantation Network (OPTN) Board of Directors approved a revision to the liver allocation policy.  [Allocation of organs is addressed in 42 C.F.R. 121.8.]  The revised policy is raising concerns in rural areas, and its implementation has been postponed.  Livers have been allocated using a medical urgency formula through a local/regional/national sequence.  The revised policy “eliminates the use of DSA [donation service area] or [OPTN] region in liver allocation or in scoring liver candidate exceptions,” and “would allocate livers to candidates within 150, 250, or 500 nautical miles (nm) of donor hospitals before offering them nationally.”  Under the revised policy’s expansion of geographic availability, rural transplant centers will likely have access to fewer livers.