LAUSR

Liver transplantation (LTx) is life-saving therapy for a variety of end-stage liver diseases, including cirrhotic, neoplastic, and metabolic disorders. As the cohort of patients with a disease process benefiting from LTx grows, the number of patients added to the waiting list per year continues to outstrip the number of transplants performed. It is this imbalance in supply and demand for donor livers that has led to the ongoing need for refinement of the systematic process in which donor livers are given to recipients: donor allocation. Over the past decade, a number of changes have come about that have significantly altered allocation protocols. This chapter focuses on these changes as well as the current allocation protocols. Although related, candidate selection is distinct from allocation, and will also be reviewed herein. We focus on deceased, adult LTx, and will not discuss living donor or pediatric LTx.