Liver transplant allocation (Wash Post article)

Interesting article. I also think it would be good to advocate a policy that gives PSC-type of patients more chances since MELD score is not the best predictor of outcome. Also interesting comment that this new policy make things even worse for PSC patients. I didn’t quite understand comment 2 though.

"One number determines who gets an organ transplant. And it’s horribly unfair…

  1. More livers will ship to cities with big transplant centers and away from rural, Southern and Midwestern regions. 2. Centers will be incentivized to list extremely ill high-MELD patients, many of whom will have liver disease from alcohol and NASH. 3. It will become even harder for people such as Nate to get livers."

Interesting read. I know it’s selfish and self serving but it does pain me everytime i go to clinic and ask them for a run down of the diseases making up the list of people above me and they reply with 90% Hep C or Alcoholism.

Maybe this makes me a bad person or just a desperate man. But I’m not sure i could be convinced to change my feeling or thinking.


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I feel the same way

Thanks for sharing this article with the forum. It’s unfortunate the way the allocation has changed especially the 500 mile radius. I do wish more exception points could be considered to include PSC patients. I have great concerns that the person who has destroyed their lives drinking away their livers would have a greater chance of transplant than the patient with auto-immune diseases like PSC. Our country has taken such a strong stance against smoking, but lawmakers refuse to address alcohol abuse as it should be. I think one reason is that so many of them are heavy drinkers themselves.
Let’s not give up hope though that each of us here in this forum who need transplants one day will have that opportunity when they so desperately need one.


My understanding is that UNOS organization makes the rules, but patient groups and public (and maybe lawmakers) can try to influence it.

Here is some request for comments opportunities:

The board:

So I think PSC patients should actively advocate UNOS policy changes.