Liver and Intestine

• Patient questions and answers for updates to MELD and PELD (PDF - 355 KB) New
• Improving liver allocation general implementation FAQ (PDF - 232 KB)
• Improving liver allocation MELD 3.0 FAQ (PDF - 144 KB)
• Improving liver allocation pediatric FAQ (PDF - 226 KB)
• Improving MELD, PELD and status 1A/1B: FAQs for patients and caregivers (PDF - 148 KB)
• MELD and PELD calculators user guide (PDF - 266 KB)

Implementation Overview: Improving Liver Allocation

 

 

 

 

 

 

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Improving Liver Allocation: MELD, PELD, Status 1A and Status 1B (PDF - 667 KB)

• Six-month monitoring report for updated liver urgency policy shows continued success (10/18/2024)
• Three-month monitoring report for updated liver urgency policy shows progress (06/04/2024)
• Updates to medical urgency scoring of liver transplant candidates in effect (09/11/2023)
• Webinars to address improvements to MELD, PELD, Status 1A/1B (06/05/2023)

• Twelve-month monitoring report: MELD 3.0 and PELD-CR (PDF - 2 MB) (2/2025)
• Six-month monitoring report: MELD 3.0 and PELD-CR (PDF - 3 MB) (8/2024)
• Three-month monitoring report: MELD 3.0 and PELD-CR (PDF - 4 MB) (4/2024)

The liver allocation policy makes matches by comparing medical and logistical characteristics about deceased donors and transplant candidates. In general, the first matches will be made for the most urgent candidates listed at transplant programs within a certain distance from the donor hospital. The specific sequence used will vary according to certain facts about the donor, such as the donor’s age and mechanism of death.

View examples that illustrate the allocation sequence based on different donor characteristics.

• Liver variance list (PDF - 519 KB) (3/2020)
• Questions and answers for patients about liver allocation

NLRB and liver distribution-related policy notices

• New policy establishes expedited placement of livers (3/25/2021)
• New national liver and intestinal organ transplant system in effect (2/4/2020)
• Updated liver and intestinal organ allocation policy implemented Feb. 4, 2020 (1/18/2020)
• Assessing liver transplant candidates' level of illness (8/21/2019)
• Liver allocation policy reverted to DSA and regions (5/23/2019)
• Work in progress to revert to DSA-based system due to court order (5/20/2019)
• New national liver transplant system takes effect (5/14/2019)
• Liver distribution policy, national liver review board, deferred until May 14 (4/23/2019)
• Board approves updated liver distribution system (12/2018)

• Two Year Monitoring Report of Liver and Intestine Acuity Circle Allocation Removal of DSA and Region as Units of Allocation (PDF - 8 MB) (8/5/2022)
• Expedited liver placement pathway six-month post policy Implementation Monitoring Report (PDF - 2 MB) (12/8/2021)
• Eighteen-month monitoring report available for removal of DSA and region as units of allocation (PDF - 4 MB) (12/3/2021)
• Fifteen-month monitoring report available for removal of DSA and region as units of allocation (PDF - 2 MB) (8/9/2021)
• One-year monitoring report available for removal of DSA and region as units of allocation (PDF - 6 MB) (4/5/2021)
• Nine-month monitoring report available for removal of DSA and region as units of allocation (PDF - 6 MB) (2/1/2021)
• Six-month monitoring report available for removal of DSA and region as units of allocation (PDF - 8 MB) (10/18/2020)
• Two-month monitoring report available for removal of DSA and region as units of allocation (PDF - 2 MB) (4/27/2020)

Current scores

• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 3 MB) (09/2025)

Previous scores

• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 3 MB) (03/2025)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 2 MB) (09/2024)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 2 MB) (03/2024)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 2 MB) (09/2023)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 2 MB) (03/2023)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 2 MB) (09/2022)
• Median MELD at Transplant Around Liver Donor Hospitals and Median PELD at Transplant Within the Nation (PDF - 3 MB) (06/2022)
• Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF - 376 KB) (03/2022)
• MTS comparison (03/2022)
• Updated monitoring report available for liver, intestine policy (PDF - 2 MB) (9/2021)
• Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF - 447 KB) (10/2021)
• MTS comparison (10/2021)
• Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF - 459 KB) (03/2021)
• Median MELD at Transplant by 250 Nautical Mile Circles Around Liver Transplant Programs and Median PELD at Transplant Within the Nation (PDF - 445 KB) (9/2020)
• Median MELD at Transplant by circles reference effective March 25, 2020 (PDF - 450 KB) (3/9/2020)

• Frequently Asked Questions: Calculate Median MELD at Transplant (MMaT) around the Donor Hospital and Update Sorting within Liver Allocation (PDF - 168 KB) (PDF: 06/2022)
• NLRB educational webinar (2/2020)
• NLRB update (10/2019)
• NLRB webinar presentation (PDF - 570 KB) (PDF: 10/2019)
• NLRB for members (4/2019)
• NLRB for review board members (4/2019)

NLRB and liver distribution-related policy notices

• Updated median MELD at transplant scores in effect March 26; median PELD at transplant score unchanged (3/26/2025)
• Updated median MELD at transplant scores in effect; revisions made to MMaT and MPaT scores (10/14/2022)
• Two-year monitoring report summarizes National Liver Review Board activity (7/25/2022)
• Report lists median MELD at transplant score for each donor hospital (6/23/2022)
• Educational webinar addresses NLRB process (10/1/2019)
• National liver review board is implemented (5/14/2019)

• 6-month monitoring report on HCC exception and diagnosis code updates (PDF - 1 MB) (8/2025)
• Guidance for Multivisceral Transplant Candidates One-Year Monitoring Report (PDF - 1 MB) (3/2025)
• National Liver Review Board Enhancements Monitoring (PDF - 2 MB) (3/2025)
• Median MELD at Transplant Around the Donor Hospital Two-Year Monitoring Report (PDF - 5 MB) (3/2025)
• National Liver Review Board Two Year Post-Acuity Implementation Report (PDF - 2 MB) (7/2022)
• Updated 18-month monitoring report available for National Liver Review Board (3/16/2022)
• Updated monitoring report now available for liver, intestine policy (12/14/2021)
• Updated monitoring report available for liver, intestine policy (9/15/2021)
• Updated 12-month monitoring report available for National Liver Review Board (5/12/2021)
• Updated 9-month monitoring report available for liver policy (1/15/2020)