Distribution of livers from deceased donors. Current allocation rules and algorithms

Eurotransplant is responsible for the allocation of organs from deceased donors in Germany. The guidelines governing this allocation process have been developed and are continuously updated by the German Medical Association and are based on urgency and outcome of the planned transplantation. The allocation sequence for donor livers is based on the model of end-stage liver disease (MELD) score, which is calculated using three laboratory values, bilirubin, creatinine and the international normalized ratio (INR) and allows an objective and transparent evaluation of the urgency of the transplantation. For patients with liver diseases where the MELD score does not allow an estimation of the urgency of the transplantation, special rules apply. The international cooperation among the Eurotransplant member countries especially increases the probability of finding a suitable donor organ in time for highly urgent patients and patients with special difficulties in matching characteristics.