Variations in liver allocation systems across continents with a focus on MELD exceptions

Tomohiro Tanaka; Abdul Rahman Hakeem; Ryan Chadha; Wojciech Polak; Claire Francoz; Carmen Vinaixa; Francesco Paolo Russo; Gökhan Kabacam; Pål Dag Line; Ken Liu; Prosanto Chaudhury; Anjana Pillai; Alan G Contreras; Nazia Selzner; Julie K Heimbach

doi:10.1097/LVT.0000000000000751

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Variations in liver allocation systems across continents with a focus on MELD exceptions

Journal article

Peer reviewed

Variations in liver allocation systems across continents with a focus on MELD exceptions

Tomohiro Tanaka, Abdul Rahman Hakeem, Ryan Chadha, Wojciech Polak, Claire Francoz, Carmen Vinaixa, Francesco Paolo Russo, Gökhan Kabacam, Pål Dag Line, Ken Liu, …

Liver transplantation, Vol.32(5), pp.748-764

05/2026

DOI: 10.1097/LVT.0000000000000751

PMID: 41100744

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Abstract

Variations in liver allocation systems world-wide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal to serve as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, Asian systems as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South American, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation. Additionally, the adoption of living donation and donation after circulatory death (DCD) is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policy, including MELD exceptions.

International Liver Transplantation Society

allocation policy

hepatocellular carcinoma

Details

Title: Subtitle: Variations in liver allocation systems across continents with a focus on MELD exceptions
Creators: Tomohiro Tanaka - University of Iowa
Abdul Rahman Hakeem - King's College Hospital
Ryan Chadha - Mayo Clinic
Wojciech Polak - Erasmus MC
Claire Francoz - Hôpital Beaujon
Carmen Vinaixa - Hospital Universitari i Politècnic La Fe
Francesco Paolo Russo - University of Padua
Gökhan Kabacam - Güven Hospital
Pål Dag Line - Oslo University Hospital
Ken Liu - Royal Prince Alfred Hospital
Prosanto Chaudhury - McGill University
Anjana Pillai - University of Chicago
Alan G Contreras - Intermountain Medical Center
Nazia Selzner - University Health Network
Julie K Heimbach - Mayo Clinic in Arizona
Resource Type: Journal article
Publication Details: Liver transplantation, Vol.32(5), pp.748-764
DOI: 10.1097/LVT.0000000000000751
PMID: 41100744
NLM abbreviation: Liver Transpl
ISSN: 1527-6473
eISSN: 1527-6473
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Language: English
Electronic publication date: 10/16/2025
Date published: 05/2026
Academic Unit: Health Management and Policy; Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9985014801102771

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