{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:57:13Z","timestamp":1776869833392,"version":"3.51.2"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4748,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>In 1999, the Institute of Medicine suggested that instituting a continuous disease severity score that de-emphasizes waiting time could improve the allocation of cadaveric livers for transplantation. This report describes the development and initial implementation of this new plan. The goal was to develop a continuous disease severity scale that uses objective, readily available variables to predict mortality risk in patients with end-stage liver disease and reduce the emphasis on waiting time. Mechanisms were also developed for inclusion of good transplant candidates who do not have high risk of death but for whom transplantation may be urgent. The Model for End-Stage Liver Disease (MELD) and Pediatric End-Stage Liver Disease (PELD) scores were selected as the basis for the new allocation policy because of their high degree of accuracy for predicting death in patients having a variety of liver disease etiologies and across a broad spectrum of liver disease severity. Except for the most urgent patients, all patients will be ranked continuously under the new policy by their MELD\/PELD score. Waiting time is used only to prioritize patients with identical MELD\/PELD scores. Patients who are not well served by the MELD\/PELD scores can be prioritized through a regionalized peer review system. This new liver allocation plan is based on more objective, verifiable measures of disease severity with minimal emphasis on waiting time. Application of such risk models provides an evidenced-based approach on which to base further refinements and improve the model.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jlts.2002.35927","type":"journal-article","created":{"date-parts":[[2003,4,24]],"date-time":"2003-04-24T00:50:07Z","timestamp":1051145407000},"page":"851-858","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":597,"title":["The new liver allocation system: Moving toward evidence-based transplantation policy"],"prefix":"10.1097","volume":"8","author":[{"given":"Richard B.","family":"Freeman","sequence":"first","affiliation":[]},{"given":"Russell H.","family":"Wiesner","sequence":"additional","affiliation":[]},{"given":"Ann","family":"Harper","sequence":"additional","affiliation":[]},{"given":"Sue V.","family":"McDiarmid","sequence":"additional","affiliation":[]},{"given":"Jack","family":"Lake","sequence":"additional","affiliation":[]},{"given":"Erick","family":"Edwards","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Merion","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Wolfe","sequence":"additional","affiliation":[]},{"given":"Jeremiah","family":"Turcotte","sequence":"additional","affiliation":[]},{"given":"Lewis","family":"Teperman","sequence":"additional","affiliation":[]}],"member":"276","reference":[{"key":"BIB1","year":"1998","unstructured":"Federal Register. [FR Doc. 98-8191] 42 CFR Part 121, April 2, 1998:16296."},{"key":"BIB2","year":"2002","unstructured":"Components of the CTP score employed in the previous liver allocation policy. Available at: www.unos.org. Accessed July 31, 2002."},{"key":"BIB3","first-page":"82","volume-title":"Organ Procurement and Transplantation: Assessing Current Policies and the Potential Impact of the DHHS Final Rule","year":"1999","unstructured":"Committee on Organ Procurement and Transplantation Policy. Organ Procurement and Transplantation: Assessing Current Policies and the Potential Impact of the DHHS Final Rule. Washington, DC: National Academy Press, 1999:82."},{"key":"BIB4","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1053\/he.2000.5852","volume":"31","author":"Malinchoc","year":"2000","journal-title":"Hepatology"},{"key":"BIB5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1053\/jlts.2001.25879","volume":"7","author":"Wiesner","year":"2001","journal-title":"Liver Transpl"},{"key":"BIB6","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/00007890-200108150-00018","volume":"72","year":"2001","journal-title":"Transplantation"},{"key":"BIB7","doi-asserted-by":"crossref","first-page":"174a","DOI":"10.1053\/jhep.2001.26512","volume":"34","author":"Yao","year":"2001","journal-title":"Hepatology"},{"key":"BIB8","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1002\/hep.510300629","volume":"30","author":"Lovelet","year":"1999","journal-title":"Hepatology"},{"key":"BIB9","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1053\/he.2000.6959","volume":"31","author":"Lovelet","year":"2000","journal-title":"Hepatology"},{"key":"BIB10","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1053\/he.2000.5763","volume":"31","author":"Manjo","year":"2000","journal-title":"Hepatology"},{"key":"BIB11","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1053\/jlts.2002.31749","volume":"8","author":"Cheng","year":"2002","journal-title":"Liver Transpl"},{"key":"BIB12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"BIB13","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/jhep.2001.22172","volume":"33","author":"Kamath","year":"2001","journal-title":"Hepatology"},{"key":"BIB14","first-page":"813","volume":"104","author":"Garrett","year":"1988","journal-title":"Surgery"},{"key":"BIB15","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0025-6196(12)60211-0","volume":"60","author":"DiMango","year":"1985","journal-title":"Mayo Clin Proc"},{"key":"BIB16","first-page":"712","volume":"201","author":"Milliken","year":"1985","journal-title":"Ann Surg"},{"key":"BIB17","author":"Wolfe","year":"2002","unstructured":"Analysis for Data Request from the OPTN Liver and Intestinal Committee of 08\/01\/01. Scientific Registry of Transplant Recipients. Available at: www.ustransplant.org. Accessed July 31, 2002."},{"key":"BIB18","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1001\/archsurg.136.10.1177","volume":"136","author":"Bennett-Guerrero","year":"2001","journal-title":"Arch Surg"},{"key":"BIB19","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/00007890-199802270-00008","volume":"65","author":"Gayowski","year":"1998","journal-title":"Transplantation"},{"key":"BIB20","author":"Wolfe","year":"2002","unstructured":"Analysis for Data Request from the OPTN Liver and Intestinal Committee of 08\/01\/01 Final Report. Scientific Registry of Transplant Recipients. Available at: www.ustransplant.org. Accessed July 31, 2002."},{"key":"BIB21","author":"Wolfe","year":"2002","unstructured":"Analysis for Data Request from the OPTN Liver and Intestinal Committee of 10\/10\/01 Final Report. Scientific Registry of Transplant Recipients. Available at: www.ustransplant.org. Accessed July 31, 2002."},{"key":"BIB22","doi-asserted-by":"crossref","first-page":"s31","DOI":"10.1002\/lt.500060508","volume":"6","author":"Krowka","year":"2000","journal-title":"Liver Transpl"},{"key":"BIB23","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4065\/72.1.44","volume":"72","author":"Krowka","year":"1997","journal-title":"Mayo Clin Rev"},{"key":"BIB24","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1053\/jlts.2001.22180","volume":"7","author":"Freeman","year":"2001","journal-title":"Liver Transpl"},{"key":"BIB25","first-page":"251s","volume":"2","author":"Freeman","year":"2002","journal-title":"There is minimal variation among UNOS regions in prospectively collected MELD scores for patients receiving liver transplants"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1053%2Fjlts.2002.35927","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-200209000-00021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T15:04:17Z","timestamp":1737731057000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-200209000-00021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,9]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2002]]}},"URL":"https:\/\/doi.org\/10.1053\/jlts.2002.35927","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2002,9]]}}}