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. 2022 Jan 20;12(1):32–42. doi: 10.5662/wjm.v12.i1.32

Table 4.

Conditions eligible for non-hepatocellular carcinoma standard model for end-stage liver disease-exceptions

Condition
Requirements for exception points
MELD score assigned
CCA Un-resectable hilar CCA with biopsy/cytology consistent with malignancy or CA19-9 > 100 U/mL or aneuploidy MMaT-3
Center must have written protocol regarding selection of criteria, neoadjuvant therapy, operative staging for metastatic disease
Imaging to exclude metastatic disease
HPS Evidence of portal hypertension without any evidence of underlying significant pulmonary disease MMaT-3
PaO2 < 60 mmHg on room air
ECHO or lung scan confirming intra-pulmonary shunt
POPH Evidence of portal hypertension along with MPAP > 35 mmHg and PVR > 3 woods unit MMaT-3
MPAP < 35 mmHg and PVR < 5.1 woods unit post treatment of pulmonary hypertension
FAP Biopsy proven amyloid along with TTR gene mutation and able to walk independently MMaT-3
Must be on heart transplant wait list or EF > 40% on ECHO within 30 d
Cystic fibrosis Genetic analysis confirmation needed MMaT-3
FEV1 below 40% of predicted FEV1 with 30 d prior to initial request
HAT HAT within 2 wk of OLT 40
Primary hyperoxaluria AGT deficiency proven on liver biopsy/genetic analysis MMaT
On kidney transplant list with eGFR ≤ 25 mL/min on two instances 42 d apart

CA19-9: Carbohydrate antigen 19-9; FEV1: Forced expiratory volume at one second; TTR: Transthyretin; AGT: Alanine glyoxylate aminotransferase; MELD: Model for end-stage liver disease; CCA: Cholangiocarcinoma; HPS: Hepatopulmonary syndrome; MPAP: Mean pulmonary artery pressure; FAP: Familial amyloid polyneuropathy; HAT: Hepatic artery thrombosis; PVR: Pulmonary vascular resistance; POPH: Portopulmonary hypertension.