Review boards
Review board members quickly review specific, urgent-status patient registrations on the OPTN heart, liver and lung transplant waiting lists. Review board members collectively determine whether these listings are appropriate, based entirely on clinical information that complies with OPTN policies. Separate boards review exceptions for each organ.
For complete review board member lists, please contact UNOS Customer Service at 800-978-4334.
Heart review board
Operational guidelines
These guidelines instruct review board members and UNOS staff about the confidential medical peer review process. The guidelines specify requirements for review board members, initial review and appeal process steps, process time frames and possible outcomes.
Adult Heart Regional Review Board (RRB) Operational Guidelines (PDF - 577 K; 06/2021)
National Heart Review Board for Pediatrics Operational Guidelines (PDF - 569 K; 06/2021)
Guidance
These resources are not OPTN Policy, so they do not carry the monitoring or enforcement implications of policy. They are not official guidelines for clinical practice, nor are they intended to be clinically prescriptive or to define a standard of care. These resources are intended to provide guidance to transplant programs and review boards.
HCM/RCM exception reviews (hypertrophic/restrictive cardiomyopathy)
Review board guidance for HCM/RCM exception requests (PDF - 674 K; 10/2018)
Effective 10/18/2018
Adult CHD exception reviews (congenital heart disease)
Review board guidance for adult CHD exception requests (PDF - 180 K; 12/2017)
Adult heart exception reviews (status 2 cardiogenic shock candidates)
Review board guidance for adult heart exception requests (PDF - 448 K; 2/2021)
Effective 2/9/2021
Pediatric heart exception reviews (status 1A/status 1B candidates)
Review board guidance for pediatric heart exception requests (PDF - 619 K; 2/2021)
Effective 2/9/2021
If a transplant hospital submits an adult status exception request that request will be evaluated by review board members in the following regions:
| Transplant hospital region | Assigned review board region (Oct. 2024 - Sept. 2025) |
|---|---|
| 1 | 8 |
| 2 | 1 |
| 3 | 5 |
| 4 | 3 |
| 5 | 4 |
| 6 | 2 |
| 7 | 11 |
| 8 | 6 |
| 9 | 10 |
| 10 | 7 |
| 11 | 9 |
Liver review board
Operational Guidelines
These guidelines instruct review board members and UNOS staff about the confidential medical peer review process. The guidelines specify requirements for review board members, initial review and appeal process steps, process time frames and possible outcomes.
National liver review board guidelines (PDF; 06/2022)
Guidance
These resources are not OPTN Policy, so they do not carry the monitoring or enforcement implications of policy. They are not official guidelines for clinical practice, nor are they intended to be clinically prescriptive or to define a standard of care. These resources are intended to provide guidance to transplant programs and review boards.
Adult MELD exception review
This document summarizes available evidence to assist clinical reviewers in approving candidates for adult MELD exceptions.
Adult MELD exception review guidance (7/2023)
Pediatric MELD/PELD exception review
This document summarizes available evidence to assist clinical reviewers in approving pediatric candidates for status 1B exceptions and MELD or PELD exceptions.
Pediatric MELD/PELD exception review guidance (7/2023)
Adult MELD exceptions for HCC (Hepatocellular carcinoma)
This guidance document is intended to provide recommendations for the review board considering HCC cases which are outside standard policy.
Adult MELD exception review for HCC guidance (PDF; 4/2023)
Lung review board
Operational guidelines
These guidelines instruct review board members and UNOS staff about the confidential medical peer review process. The guidelines specify requirements for review board members, initial review and appeal process steps, process time frames and possible outcomes.
Lung review board guidelines (PDF; 3/2023)
Lung review board clinical guidance (PDF; 3/2023)