Local versus distant (donor organs are first offered locally within a given OPO).In summary, the priority of an individual patient on the UNOS waiting list for a donor liver depends on the following factors: Waiting time for liver allocation is only a factor when patients have the same MELD score. Recipients are chosen on the basis of medical urgency within each ABO blood group. UNOS uses a computerized database to distribute organs in a fair manner. In general, a donor liver is matched to a potential recipient on the basis of several factors: ABO blood type, body size, degree of medical urgency and MELD score. The etiology turned out to be relatively unimportant and was also regarded as relatively subjective. The score turned out to be predictive of prognosis in chronic liver disease in general and–with some modifications–came to be applied as an objective tool in assigning need for a liver transplant. At that point it was called the "Mayo End-stage Liver Disease" score.The original version also included a variable based on the underlying etiology (cause) of the liver disease. MELD was originally developed at the Mayo Clinic. This score is now used by United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Turcotte-Pugh (CTP) score. It was initially developed to predict death within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure and was subsequently found to be useful in determining prognosis and then prioritizing for receipt of a liver transplant. MELD is a scoring system for assessing the severity of chronic liver disease.
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