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Six-Month Report Highlights Key Updates in Liver Transplant Candidate Diagnoses and Treatment Options

Published on: Monday, September 8, 2025

The Organ Procurement and Transplantation Network (OPTN) released a six-month data report on outcomes following updates to how treatment options are reported for liver candidates with exception scores due to hepatocellular carcinoma (HCC), as well as changes to the diagnostic terminology for liver candidates and recipients with cirrhosis caused by certain disorders.

For candidates with HCC exceptions, liver transplant programs can now specify whether their condition is being treated locoregionally via histotripsy or other forms of therapy. In the six months after implementation, four candidates were reported as undergoing histotripsy and another 44 were reported as receiving a different, unspecified locoregional treatment.

The policy updates also discontinued the previous liver diagnosis of cirrhosis based on “Fatty Liver (NASH),” establishing in its place two alternates:

  • Cirrhosis due to “Metabolic Dysfunction-Associated Steatohepatitis (MASH)” and
  • Cirrhosis associated with “Metabolic Dysfunction and Alcohol-Related Associated Liver Disease (MetALD)”

At six months post-implementation, the overall proportion of these combined diagnoses did not change in the liver transplant candidate population, accounting for nearly 19 percent of all liver candidates listed and transplanted. However, the distinction between the two conditions allowed greater precision among the diagnoses, with nearly 16 percent of candidates and recipients overall reported as having MASH and about 3 percent reported with MetALD.

The OPTN Liver and Intestinal Organ Transplantation Committee will continue to monitor effects of the changes.