The following 3 charts by Donor Age spell out the dynamic rank order of liver patients each time a donor comes up.
*** Remember the Wait List is very volatile ... many patients move up/down the WL based on MELD score re-certification and on/off the WL, hopefully due to getting transplanted!
The donor's hospital staff with the help of the Donate Life folks enter in the donor's vital information (age, blood type, size, etc) into UNOS' computer system to begin the matching process.
The 1st chart is for Adult Donors which I will use as my example. So if there's an 18+ age donor, UNOS looks to see if there's any suitable Status 1A (adult or peds) in the donor's Region. They will become the #1 patient for that donor. If there are (2) 1A patients, whoever has the longest wait time becomes #1 patient for that donor and the other 1A becomes #2 (back-up) patient.
If no Status1As, then UNOS looks to see if there's any suitable Status 1Bs in the donor's Region.
After that, UNOS has a toggle system between the OPO and Region for MELD 40 down to MELD 35, ranking the sickest eligible patients. Because of travel distance and liver "shelf life," it looks within the OPO first, then out to the Region for each MELD point.
After searching for eligible MELD 35+s and 1A/1Bs, then UNOS looks for the sickest MELD patient within the donor's OPO (MELD 34 down to MELD 15).
This is why your overall Regional Wait List is important and when your Region typically has low 1A/1B and 35+s, then this is why your OPO low wait list is key. 73% of livers in 2017 got allocated at the OPO level (under MELD 35).
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Transplant911
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It’s just how the patients get ranked when a donor liver becomes available. If you ever want to discuss your personal status over the phone, just grab a time to talk at the Contact Us tab at CompareTransplantCenters.com.
Maybe I can help show your relative rank. What is your current meld score, hospital and blood type? I’ll show all the patients ahead of you. Keep in mind this is just a snapshot in time.
Thank you for replying, yes i gathered that is what the graph was showing, i just didn't understand the abbreviated letters were .Yes i think i would like that actually. Would be interesting to see where about i am . Thank you . Will be in touch. Kind regards linda
I am sure this will be valuable information for those on the transplant list however, thankfully I am not on nor do I want my liver disease to progress to that stage, nevertheless I am curious.
How do comorbidities affect one’s score and for people with rhesus negative blood types, how likely are they to get a match in comparison to rhesus positive blood groups?
Absolutely. Walk back your liver disease if you can, do everything in your power to maintain/keep Liver 1.0 as I lovingly call it. The only factors in the MELD score are bilirubin, creatinine, INR and serum sodium. Here is the MELD-NA calculator that ranks pre-transplant patients. optn.transplant.hrsa.gov/re...
The rhesus factor is not factored in for a liver transplant, only straight O-A-B-AB blood types. The liver is easy like that, just blood type, size and MELD score determines the rank.
Thank you Transplant911 I am trying my best to reverse the current situation. My diet is good, I only drink water or occasional diet fizzy drink, I take regular exercise yet I am still overweight. My biggest worry is the large amount of tablets that I must take on a daily basis for other illnesses. This of course damages my liver but I have no control over this.
My heart breaks when I read some of the posts for those desperately waiting for a life saving transplant and I am overjoyed when members become the great gift of a liver, despite it being from someone else’s misfortune.
When I moan about my tiredness, I really should pinch myself to remind me how much worse the symptoms are for many of our members.
My friend’s aunt survives a liver transplant, breast cancer, two strokes and many other critical illnesses, she is an inspiration at 71 years of age and is still dancing with the aid of her walking frame.
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