Background: To address geographic disparity in liver allocation, a new organ distribution system consisting of 4 or 8 districts has been proposed (Gentry, Am J Transplant 2013). The OPTN Liver Committee is considering including proximity points for candidates within 150 or 250 miles of the donor.

Purpose: We evaluated the impact of proximity preference on disparity in liver distribution.

Methods: We used the liver simulated allocation model (LSAM) to project disparity (variance in median MELD/PELD at transplant by DSA) and transport burden (percentage of organs transported by flying) with bonus proximity MELD/PELD points.

Results: Broader sharing in the current 11 regions was projected to increase variance in median MELD/PELD at transplant compared with a current policy simulation. The 8- and 4-district maps decreased this variance by half (Figure 1). Adding proximity points did not substantially reduce this disparity benefit, but did reduce the percentage of organs transported by flying; flight percentage was lowest for the 8-district 5-point 150-mile scenario (Figure 2, 65%).

Conclusions: Proximity MELD/PELD points can mitigate the transport burden of liver redistricting while reducing the disparity in median MELD/PELD at transplant.

CITATION INFORMATION: Gentry S, Pyke J, Schladt D, Zeglin J, Kim W, Lake J, Hirose R, Mulligan D, Israni A. Impact of Proximity MELD/PELD Points on Liver Redistricting Scenarios. Am J Transplant. 2016;16 (suppl 3).

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