TableĀ 2

Allocation models considered for liver transplantation

UrgencyFocused on pretransplant risk of dying: patients with worse outcome on the waiting list are given higher priority for transplantation (based on Child-Pugh or MELD score)
UtilityBased on maximisation of post-transplant outcome, takes into account donor and recipient characteristics: mainly used for HCC since the MELD score poorly predicts post-transplant outcome in HCC due to the absence of donor factors and lack of predicting tumour progression while waiting
BenefitCalculated by subtracting to the survival achieved with LT the survival obtained without LT. Ranks patients according to the net survival benefit that they would derive from transplantation and maximise the lifetime gained through transplantation. If applied to HCC without adjustments, it may prioritise patients at highest risk or recurrence.
  • HCC, hepatocellular carcinoma; LT, liver transplantation.