Longer Term Follow-up on Acuity Circle Allocation Strategies in Liver Transplantation
Allison J. Kwong, Ashley Jowell, Kiran Bambha, Scott W. Biggins
Abstract
Abstract Purpose of Review This review summarizes longer term follow-up of acuity circle–based distribution for livers, which was implemented on February 4, 2020. Recent Findings After 2 years of policy implementation, the likelihood of transplant increased, while removals for death or being too sick decreased. The median transplant score was unchanged, and the variance in the median MELD at transplant decreased for OPTN regions, DSA, and state. Concurrently, median distance from donor to transplant hospital and cold ischemia times increased. A slight increase in liver non-use rate and decrease in liver utilization rate has been observed. Summary Acuity circle–based distribution improved access to liver transplantation for the sickest patients through broader sharing, at the cost of increased travel and logistics. The continuous distribution framework may be an opportunity for the liver transplant community to further address geographic disparities in access to transplant in the United States.