| Home | New guidelines proposed for liver transplant candidates posted 7-11-97 The group that controls distribution of the limited number of livers available for transplant has proposed reshuffling the system that ranks transplant candidates. The change could mean more dying patients will be moved higher on the waiting list that determines who receives a transplant. The change in the list was proposed by the liver and intestinal organ transplantation committee of the United Network for Organ Sharing (UNOS), based in Richmond, Va. Committee members said the proposal would create a safety net for people who are already chronically ill and whose conditions suddenly become critical. The new policy would not change the ranking in the highest priority group, known as status 1 patients. These are people who experience sudden liver failure or who require an immediate retransplant. Within the second tier, however, the proposal suggests splitting the group into subcategories. Category 2A patients would consist of ill patients who take a turn for the worse, or "crash." Category 2B would include those who are chronically ill, but in fairly stable condition. Under the new rules, 2A patients would take precedence over the 2B group. The new proposal follows on the heels of an earlier overhaul that also triggered debate. Last November, UNOS members voted to change the criteria for ranking within status 1, giving top priority to patients most likely to survive with a new liver rather than to patients who were the sickest. The new proposal will be open for public comment until November, when UNOS will take final action. Related Sites
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