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Updated: Jan 15, 2026
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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
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Variations in liver allocation systems across continents with a focus on MELD exceptions
Tomohiro Tanaka1, Abdul Rahman Hakeem2, Ryan Chadha3
1Division of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Summary
Global liver allocation systems vary significantly by region, impacting patient outcomes. This review compares international policies, including MELD exceptions, to guide future organ allocation strategies.
Area of Science:
- Hepatology and Transplant Surgery
- Public Health Policy
- Organ Donation and Transplantation
Background:
- Liver allocation systems differ worldwide, influencing transplant outcomes.
- Optimizing organ distribution is crucial for equitable patient care.
- International collaboration is needed to refine allocation policies.
Purpose of the Study:
- To present a global overview of liver allocation systems.
- To compare regional variations and their impact on outcomes.
- To provide a reference for future policy development.
Main Methods:
- Review of liver allocation systems in Europe, Asia, North America, South America, and Australia/Canada.
- Comparison of MELD exceptions, particularly for hepatocellular carcinoma.
- Discussion of living donation and donation after circulatory death practices.
Main Results:
- Significant regional differences exist in liver allocation criteria and MELD exception policies.
- Hepatocellular carcinoma is a primary driver for MELD exceptions globally.
- Adoption rates of living donation and DCD vary across regions.
Conclusions:
- Understanding international variations is key to optimizing global liver allocation.
- Harmonizing policies, especially for MELD exceptions, could improve transplant equity.
- This comparative analysis serves as a resource for international dialogue on organ allocation.
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