Who Decides Which Patient Will Get an Organ?
Entering Data for UNOS
The United Network for Organ Sharing (UNOS) is responsible for transplant organ distribution in the United States. UNOS oversees the assignment of many different types of transplants, including liver, kidney, pancreas, heart, lung and cornea.
UNOS receives information from hospitals and medical centers throughout the country about adults and children who need organ transplants. The medical team at Cincinnati Chidren's Hospital Medical Center that sees your child is responsible for sending information to UNOS and updating them as your child's condition changes.
Standards, or criteria, have been developed by UNOS to make sure everyone on the organ waiting list is judged fairly based on the severity of their illness and the urgency of receiving a transplant.
Once UNOS receives the data from hospitals, people waiting for a transplant are placed on a waiting list and given a "status" code. The people in most urgent need of a transplant are placed highest on the status list and are given first priority when a donor liver becomes available.
The system used to prioritize patients waiting for liver transplants is based on statistical formulas that are very accurate for predicting which patients are most likely to die soon from liver disease.
UNOS uses the Model for End-Stage Liver Disease (MELD) score for adult liver patients. This score is based on bilirubin, INR and creatinine.
Liver transplant candidates under the age of 18 are assigned a PELD (Pediatric End-Stage Liver Disease) score. The PELD score is based on factors which better predict mortality (death rate) in children: bilirubin, INR (international normalized ratio), albumin, growth failure and age when listed for transplant.
A patient's score may go up or down over time depending on the liver disease status. That is why it is important for many patients to have their MELD or PELD score reassessed a number of times while they are on the waiting list.
