Over the past 15 years, the Organ Procurement and Transplantation Network has implemented several policy changes in an attempt to create an equitable liver allocation and distribution system. Despite these efforts, geographic differences in donor organ availability and demand among the 11 United Network for Organ Sharing (UNOS) Regions determine waitlist mortality. In 2013, there were 3075 cand...

Under the current liver organ allocation system organs are on a sickest first policy as prioritized by MELD score within one of the 11 multi-state UNOS regions for MELD scores greater than 35. In the unusual circumstance in which no patient has a MELD score above 35, the organ is offered within a local area, again prioritized by the MELD score. Both UNOS regions and local distribution areas cal...

In 1998, the Department of Health and Human Services (DHHS) issued the final rule,1 in which the principles of organ allocation were defined, to govern the operation of the Organ Procurement and Transplant Network (OPTN). This rule included the following guidelines for organ allocation: (1) organs should be allocated to transplant candidates in the order of medical urgency; (2) the role of wait...

INTRODUCTION Autoimmune hepatitis (AIH) may initially present as acute liver failure (ALF). The outcome of liver transplantation (LT) in patients with AIH and ALF is not very well defined. We determined the outcome of LT in UNOS (United Network for Organ Sharing) status 1 adult patients with and without AIH using post-MELD (Model for End-Stage Liver Disease) UNOS data. MATERIAL AND METHODS Fo...

Background Liver transplantation (LT) is an important treatment for acute liver failure and end-stage liver disease. In 2002, the model for end-stage liver disease (MELD) score was incorporated to prioritize patients awaiting LT. Although there is data on how the MELD score affects waiting times, there is a paucity of literature regarding other components. We aimed to evaluate the factors affec...

Submit Manuscript | http://medcraveonline.com Abbreviations: CHLT: Combined heart and liver transplantation; FAP: Familial Amyloid Poly neuropathy; OLT: Orthotopic Liver Transplant; OHT: Orthotopic Heart Transplant; UNOS : United Network for Organ Sharing; OPTN: Organ Procurement and Transplantation Network; HLT: Heart-Liver Transplant; HRT: Heart Transplant; LIV: Liver Transplant; ECMO: Extrac...

The UNOS Liver Allocation Model (ULAM) is a simulation of the cadaveric liver allocation system in the United States. ULAM was created by the United Network for Organ Sharing (UNOS) in collaboration with Pritsker Corporation/Symix Systems, to permit comparison of multiple liver allocation policy proposals so that policies can be tested prior to implementation. ULAM is extremely adaptable, and w...

Orthotopic liver retransplantation (re-OLT) is highly controversial. The objectives of this study were to determine the validity of a recently developed United Network for Organ Sharing (UNOS) multivariate model using an independent cohort of patients undergoing re-OLT outside the United States, to determine whether incorporation of other variables that were incomplete in the UNOS registry woul...

Model for End-stage Liver Disease (MELD) measures serum bilirubin (mg/dL), serum albumin (g/dL), International Normalised Ratio (INR) for prothrombin time. MELD score accurately predicts survival in 3 months for cirrhotic patients on the waiting list of liver transplantation. In about 15% of patients, it does not accurately predict survival and hence MELD-Na is recommended. MELD score is a poor...

OBJECTIVE There are no guidelines to establish the indications and contraindications for a simultaneous heart and kidney transplantation. We report our single-institutional experience with simultaneous heart and kidney transplantation. METHODS Retrospective chart review. RESULTS Between 1995 and 2006, 13 patients with co-existing end-stage heart and renal failure underwent simultaneous hear...