Criteria for liver transplant is overhauled

Associated Press

WASHINGTON — Donated livers will be distributed to waiting patients according to medical criteria, replacing a system that relies heavily on how long somebody has been on the waiting list, the nation’s transplant network agreed Thursday.

The idea is to better predict which patients will die without a transplant.

"It’s a much more objective way to rank patients," said Dr. Richard Freeman, a liver surgeon at Tufts University, who chairs the liver committee for the United Network for Organ Sharing.

The transplant network, meeting in Alexandria, Va., voted 33-0 to implement the new system, though it cannot take effect until the network’s computers are reprogrammed, probably in February.

Development of the system began amid a fight over the fairness of geographic boundaries that govern the distribution of organs.

Because patients and donors are not evenly distributed around the country, the wait for a liver is much longer in some places than it is in others. Critics say it’s wrong for a patient in one city to die while a relatively healthy patient elsewhere gets a transplant.

That fight has cooled, and advocates of the new liver distribution method hope critics will appreciate the effort to get livers to the sickest patients, at least within each area.

"This is science now," Freeman said. "We’re looking at this in scientific ways rather than emotional ways, which is really good for patients."

Still, the geographic boundaries remain. Patients will be able to compare the score needed to get a liver in one part of the country vs. another.

Under the current system for distributing livers, patients are grouped into four broad categories. Within each group, those waiting the longest get first chance at the livers.

But many transplant experts believe waiting time is a poor way to measure how sick a patient is. For instance, some doctors encourage their patients to get on the list before they really need a transplant so they can accumulate waiting time and be closer to the top when they do need it.