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

The Feasibility of Changing HCC MELD Exception Criteria to an Exclusive DCD-Only Option: A Strategy to Increase DCD Utilization

G. J. McKenna, P. Schultz, M. Finotti, M. Rosenzweig, A. Gupta, S. H. Lee, A. Wall, E. Martinez, J. Bayer, H. Fernandez, N. Onaca, R. Ruiz, G. Testa

Baylor Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX

Meeting: 2022 American Transplant Congress

Abstract number: 232

Keywords: Donors, marginal, Donors, non-heart-beating, Hepatocellular carcinoma, Liver transplantation

Topic: Clinical Science » Liver » 59 - Liver: Expanding the Donor Pool* (Liver: MELD Allocation / Donor Issues)

Session Information

Session Name: Expanding the Donor Pool (MELD Allocation/Donor Issues)

Session Type: Rapid Fire Oral Abstract

Date: Monday, June 6, 2022

Session Time: 3:30pm-5:00pm

 Presentation Time: 4:40pm-4:50pm

Location: Hynes Room 312

*Purpose: Outcomes of DCD liver transplantation is comparable to DBD but routine utilization of DCD liver grafts is surprisingly uneven in the US. A more uniform and broader utilization of DCD liver grafts would significantly ease supply-demand pressure. The greatest benefit would be seen for HCC patients. We propose a new HCC Exception Criteria system where priority points would only be allocated for the use of DCD liver allografts. The implementation of such system would nudge transplant centers toward the utilization of DCD liver grafts. This study assesses whether the present supply of DCD liver grafts would match the new demand of the proposal

*Methods: All patients transplanted from 2010-2021 using HCC Exception priority points and for the same period all DCD livers recovered and transplanted were identified in the UNOS database. To detect trends of utilization, the data was stratified by year and UNOS region.

*Results: In 2020, 1063 HCC Exception patients were transplanted and overall 831 DCD liver grafts were transplanted. If these DCD liver had been allocated solely to HCC patients, 78.2% of demand would have been met. Figure 1 outlines the incidence of HCC exception transplants, DCD livers recovered, and DCD livers transplanted per year from 2010-2021. The graphs in Fig 1 represents the trends in number of HCC exception transplants, DCD liver graft recovered and DCD liver grafts transplanted in each UNOS Region.–Regions 3, 8, 10 have performed a number of DCD liver transplants that exceeds the number of HCC MELD Exception Criteria transplants –Regions 2, 4, 5, 6, 11 have not performed a number of DCD transplants to fulfill the HCC Exception Criteria transplant demand. Interestingly, the number of DCD liver grafts recovered in this region might have met demand had center selection criteria been expanded. –Regions 1, 7, 9 have not recovered enough DCD transplants to meet demand for HCC Exception Criteria transplants and would need to change practices similar to other regions to meet demand.

*Conclusions: Several UNOS regions have shown steady increase in DCD liver utilization and have reached the level where they could meet the demand to transplant all HCC patients using DCD allograft. If such utilization increase could be adopted simply following the proposed HCC exception priority point, in the regions presently underutilizing DCD liver grafts, the US would witness a significant positive impact on organ supply. .

  • 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:

McKenna GJ, Schultz P, Finotti M, Rosenzweig M, Gupta A, Lee SH, Wall A, Martinez E, Bayer J, Fernandez H, Onaca N, Ruiz R, Testa G. The Feasibility of Changing HCC MELD Exception Criteria to an Exclusive DCD-Only Option: A Strategy to Increase DCD Utilization [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-feasibility-of-changing-hcc-meld-exception-criteria-to-an-exclusive-dcd-only-option-a-strategy-to-increase-dcd-utilization/. Accessed May 25, 2025.

« Back to 2022 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