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Response to Feb. 14th posting
February 25, 2003

The February 14th message board posting from a person awaiting a liver
transplant at UCSF was brought to my attention. I have not seen the
letter in question but am inquiring about it to ensure we respond --
perhaps a response has already gone out.

For the general interest of forum readers, there may be some misunderstanding of the roles of the transplant center and UNOS. The
transplant center determines whether to accept any particular patient or
living donor. The UNOS allocation system becomes involved only after
the center has agreed to list a patient for a deceased donor transplant.
UNOS is not involved in any determinations of who can be a suitable
living donor for a given patient, although once living donor transplants
occur UNOS maintains data on the transplant and the outcome for donor
and recipient.

The MELD scoring system uses common, objective laboratory tests to
assess a patient's risk of short-term death without a liver transplant.
As the poster noted, the minimum (least urgent) MELD score is 8; the
maximum (most urgent) is 40, and thus far many liver transplant
candidates have been transplanted with scores above 20. I cannot
address the assertion that a minimum score of 10 is required for a
transplant listing. This may be a decision of the specific transplant
center but is not UNOS policy.

The UNOS web site contains information about MELD and the related
formula for children known as PELD.

Here is a link to a brochure available in PDF format
that answers common questions about MELD and PELD:

I hope this is helpful.

Joel Newman, UNOS Communications


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