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This fall 2017, the Liver and Intestinal Organ Transplantation Committee proposes the establishment of a National Liver Review Board, along with corresponding guidance documents. There have been notable changes in the post-public comment phase, such as re-calculating the median MELD score for candidates every 180 days and excluding nationally shared livers from the MMaT score. The implementation is expected in the summer of 2018. Additionally, changes to the HCC criteria for auto approval have been approved by the Board of Directors in December 2016, with a planned implementation in the fourth quarter of 2017. For more information, questions can be directed to Julie Heimbach, MD, Committee Chair, or Matt Prentice, MPH, Committee Liaison.
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Liver and Intestinal Organ Transplantation Committee Fall 2017
Recent Public Comment Proposals • Proposal to Establish a National Liver Review Board & corresponding guidance documents • Board of Directors approved in June 2017 • 2 post-public comment changes: • All candidates will receive the re-calculated median MELD at transplant score every 180 days (this was discussed by community during public comment) • Will exclude nationally shared livers from the MMaT score • Anticipated implementation - Summer 2018
Policy Implementation Dates • Changes to HCC criteria for auto approval • Board of Directors Approved – Dec. 2016 • Summary of changes • Candidates within T2 but with AFP>1000 are not initially eligible for a standardized MELD exception • Eligibility criteria in policy for being included in the downstaging protocol • Implementation expected for 4th quarter 2017 • Will provide educational material before implementation
Questions? Julie Heimbach, MD Committee Chair Heimbach.Julie@mayo.edu Matt Prentice, MPH Committee Liaison Matthew.prentice@unos.org