UNOS forbids organ allocation based on any other factors,
such as age, sex, race, or socioeconomic status. It is also illegal to purchase a liver or any
In 2002, UNOS implemented a nationwide system for
prioritizing patients for liver transplantation. It is called the Model for End Stage Liver
Disease, or MELD, and it is based on a very accurate statistical formula that predicts
which people are most likely to die in the near future from their liver
The MELD score is determined by using the results of three
blood tests (bilirubin, INR, and creatinine) to determine the severity of a
person’s liver disease. The score ranges
from 6 (normal liver function) to 40 (severe liver disease).
While on the waiting list, each person’s MELD score must be
updated according to a schedule determined by UNOS. The score may go up or down over time,
depending on the status of the patient’s liver disease. A MELD score may be reassessed weekly,
monthly, every three months or annually. The higher the score, the more frequently it
will need to be reassessed.
Time spent on the waiting list has not been a factor in
liver allocation since the MELD score was introduced. For example, an ill patient with a very high
MELD score may be listed and get a liver quickly, “passing” someone who has
been on the list for a longer time but has a lower MELD score.
It is impossible to predict when a liver will become
available for transplantation. Patients
with higher MELD scores receive liver offers more quickly than patients with
lower MELD scores. In general, patients
with blood type O or B have the longest wait times, while those with blood type
A or AB generally wait a shorter time.
In order to remain active on the liver transplant waiting
list, it is essential that you understand and fulfill certain responsibilities. These include but are not limited to:
It is imperative that you or a member of your family contact
your liver transplant coordinator or another member of the transplant team regarding any of the following situations:
It is permissible for patients to be listed at
more than one transplant center simultaneously, but certain restrictions apply. UNOS regulations allow you to be listed
at more than one transplant center as long as the two centers are not in the
same geographic region.
Information about our living donor program.
Discover how our integrated, multidisciplinary group practice can provide you outstanding care.