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The Evolution of the National Liver Review Board

  • Liver Transplantation (D Mulligan, Section Editor)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To highlight the process of development and summarize the new structure of the National Liver Review Board (NLRB)

Recent Findings

The concept of an NLRB has been considered since the institution of the Model for End-Stage Liver Disease (MELD) score liver allocation system, though barriers included concerns over logistics and loss of local control. Recently, increased volume of exceptions combined with an increased transplant rate for exception versus non-exception patients and growing concern over inequality within the regional system led to a reconsideration of an NLRB. A proposal was recently approved by the Governing Board of the Organ Procurement and Transplantation Network (OPTN) which includes the specific structure (three separate boards including one for pediatric cases, one for hepatocellular carcinoma, and one for all other exceptions), as well as a significant change to the exception scores, which will be set either at or just below the median MELD at the time of transplantation (MMaT).

Summary

This system may improve efficiency and consistency across the regions and improve the disparity between exception and non-exception patients awaiting transplantation in the USA.

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Abbreviations

MELD:

Model for End-Stage Liver Disease

OPTN:

Organ Procurement and Transplantation Network

MMaT:

Median MELD at transplantation

CTP:

Child-Turcotte-Pugh

References

Papers of Particular Interest, Published Recently, Have Been Highlighted as: •• Of major importance

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Author information

Authors and Affiliations

  1. Division of Transplantation Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Keisha Bonner & Julie K. Heimbach

  2. Division of Transplantation Surgery, UCSF, San Francisco, CA, USA

    Ryo Hirose

Authors
  1. Keisha Bonner
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  2. Ryo Hirose
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  3. Julie K. Heimbach
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Corresponding author

Correspondence to Julie K. Heimbach.

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The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Liver Transplantation

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Bonner, K., Hirose, R. & Heimbach, J.K. The Evolution of the National Liver Review Board. Curr Transpl Rep 5, 7–13 (2018). https://doi.org/10.1007/s40472-018-0176-y

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