One-year monitoring report addresses liver exception guidance for multivisceral candidates

Published on: Friday, April 4, 2025

The Organ Procurement and Transplantation Network (OPTN) published a data report describing outcomes from the first 12 months after clinical guidance was published recommending how to request an exception score for liver candidates needing a multivisceral transplant. Multivisceral transplants involve other abdominal organs transplanted from the same donor as the liver, including intestine and potentially pancreas and/or kidney.

Few listings have occurred for multivisceral transplantation because it is a rare need, but the following trends were observed:

• A greater number of multivisceral candidates applied for and received a liver exception after publication of the guidance than in the year prior to its publication.
• The number of multivisceral candidates with an exception, and who were removed from the waiting list due to death or being too sick to transplant, increased by three.
• By comparison, the number of multivisceral candidates without an exception, and who were removed from the waiting list due to death or being too sick to transplant, decreased by six.
• Multivisceral transplants increased by two transplants, and more recipients were transplanted with a liver exception than in the pre-policy period.

The OPTN Liver and Intestinal Organ Transplantation Committee will continue to monitor effects of the guidance, and another report is planned for next year covering the two-year period after publication of the clinical guidance.