ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Early Review of Liver Acuity Circles Allocation

S. Noreen1, J. Heimbach2, J. Pomposelli3, M. Cafarella1, J. Trotter4

1UNOS, Richmond, VA, 2Mayo Clinic, Rochester, MN, 3UCHealth, Aurora, CO, 4BSWHealth, Dallas, TX

Meeting: 2021 American Transplant Congress

Abstract number: 696

Keywords: Allocation, Liver, Liver transplantation, Resource utilization

Topic: Clinical Science » Public Policy » Non-Organ Specific: Public Policy & Allocation

Session Information

Session Name: Non-Organ Specific: Public Policy & Allocation

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Acuity circles (AC) allocation was implemented on February 4, 2020, followed shortly by the declaration of national emergency for COVID-19. The goal of this policy was to broaden distribution of livers, particularly for highly medically urgent candidates.

*Methods: OPTN liver waitlist, transplant, and donor data were used. Cohorts of deceased donor liver-alone transplants for the pre- (2/5 – 7/2/2019) and post-eras (2/4 – 6/30/2020), as well as cohorts of liver waitlist registrations added, liver-alone waitlist registrations removed due to death or too sick to transplant, and deceased liver donors during 2/5 – 8/6/2019 (pre-policy) and 2/4 – 8/4/2020 (post-policy) were assessed.

*Results: Similar volumes of deceased liver donors were recovered pre- and post-policy (4545 vs. 4564). While 375 fewer new registrations were added to the liver waitlist post-policy largely due to COVID-19, similar numbers of registration removals occurred (1093 pre- vs. 1020 post-policy) (Figure 1). There were fewer transplants overall post-policy (2997 vs. 3140 pre), with similar proportions of recipients with MELD or PELD scores of 29 and higher (51.7% pre- vs. 51.2% post-policy). However, these most medically urgent recipients received livers from farther away post-policy (Figure 2). The variation in median allocation score at transplant, as a measure of disparity across areas, has also decreased by most geographic units (Figure 3).

*Conclusions: It can already be seen that livers are being more broadly distributed for those with greater medical urgency, and geographic disparities are decreasing. However, the confounding effects of COVID-19 cannot be parsed out from potential policy effects, and continued data accumulation and monitoring of the system by the OPTN Liver Committee will be needed to determine the true effects of this policy change.

 border=

 border=

 border=

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Noreen S, Heimbach J, Pomposelli J, Cafarella M, Trotter J. Early Review of Liver Acuity Circles Allocation [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/early-review-of-liver-acuity-circles-allocation/. Accessed June 1, 2025.

« Back to 2021 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences