Variations in liver allocation systems across continents with a focus on MELD exceptions
Variations in liver allocation systems worldwide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal of serving as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, and Asian systems, as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South America, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation is presented. In addition, the adoption of living donation and donation after circulatory death is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policies, including MELD exceptions.
Authors
- Ryan Chadha (ORCID: https://orcid.org/0000-0002-7463-6912)
- Julie K. Heimbach (ORCID: https://orcid.org/0000-0002-3567-1328)
- Abdul Hakeem (ORCID: https://orcid.org/0000-0001-7266-3848)
- Claire Francoz (ORCID: https://orcid.org/0000-0001-7391-8507)
- Prosanto Chaudhury (ORCID: https://orcid.org/0000-0002-3461-4620)
- Tomohiro Tanaka (ORCID: https://orcid.org/0000-0001-6139-8444)
- Alan G. Contreras (ORCID: https://orcid.org/0000-0003-4960-2240)
- Anjana Pillai (ORCID: https://orcid.org/0000-0001-6783-2109)
- Wojciech G. Polak (ORCID: https://orcid.org/0000-0002-3096-4893)
- Gökhan Kabaçam (ORCID: https://orcid.org/0000-0002-2099-9697)
- Carmen Vinaixa (ORCID: https://orcid.org/0000-0001-5060-4556)
- Pål‐Dag Line (ORCID: https://orcid.org/0000-0002-5884-9336)
- Ken Liu (ORCID: https://orcid.org/0000-0002-0453-3168)
- Nazia Selzner
- Francesco Paolo Russo
Institutions
- Intermountain Healthcare (US)
- Oslo University Hospital (NO)
- University Health Network (CA)
- Mayo Clinic (US)
- University of Padua (IT)
- University of Toronto (CA)
- Hôpital Beaujon (FR)
- Royal Prince Alfred Hospital (AU)
- Erasmus MC (NL)
- University of Iowa Hospitals and Clinics (US)
- WinnMed (US)
- Intermountain Medical Center (US)
- Hospital Universitari i Politècnic La Fe (ES)
- University of Illinois Chicago (US)
- University of Chicago (US)
- University of Chicago Medical Center (US)
- Güven Hospital (TR)
- Mayo Clinic in Arizona (US)
- Erasmus MC Cancer Institute (NL)
- King's College Hospital (GB)
- Instituto de Investigación Sanitaria La Fe (ES)
- Erasmus MC Transplant Institute
- McGill University (CA)
Publication Details
- Journal
- Liver Transplantation
- Published
- 2025-10-16
- DOI
- https://doi.org/10.1097/lvt.0000000000000751
- Primary Topic
- Liver Disease and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00