Liver transplant waiting list limbo enforced on young people

New research has discovered young people are being forced to wait four times longer than people over the age of 60 for a liver transplant.

In 2018 changes were made to the algorithm which decides who to prioritise when people are referred to the NHS for a liver transplant. This has caused young people to be forced to the back of the queue, according to figures obtained from a BBC investigation. 

a picture of a human body with a diagram of the human body

Before the new algorithm was introduced, 26-39-year-olds would be expected to be on the waiting list for an average of 172 days, which was around 40 days longer than for patients over 60. Now, the gap has expanded to 156 days – more than five months.

Reasons for introducing the new computerised algorithm was that research found a vast number of people were dying before they received liver transplant surgery and older people, due to their bodies being frailer, were less likely to be able to survive for very long with an ineffective liver.

The ‘improved’ algorithm now analyses 21 recipient parameters, such as age, disease type and severity, and seven donor ones. Following this, it then delivers a score – the higher the score, the more likely you are to be seen quicker for a transplant.

As it stands, there are around 700 people on the liver transplant waiting list in the UK – although the number changes as new patients are added, and some have had their surgery. In extremely unfortunate cases, some people do not receive their transplant in time, with 69 people dying last year.

In response the research published by the BBC, Pamela Healy, chief executive officer at the British liver trust, said: ‘The British Liver Trust cannot comment on individual cases. However, we know that the liver transplant waiting list is the largest it has ever been and there has been a 50% increase in the number of adults waiting for liver transplant now compared with 2019/20.

‘Every day we hear heartbreaking stories from patients who are waiting for a transplant. It is really important that we increase the numbers of transplants to meet the needs of these patients, shorten their waiting times and ensure fewer people die on the waiting list and we would urge everyone to make their wishes known about being an organ donor to their loved ones. Currently only around half of the UK population have done this.’

‘The algorithm that decides how livers are allocated does appear to be saving more lives. However, we have asked senior clinicians and NHSBT to provide further clarity about the algorithm so that there is greater transparency for patients,’ Pamela said. ‘For equity a single algorithm is applied to all groups on the waiting list and we will also be asking NHSBT to explain how the needs of all patients including those with rare indications or those with multiple liver conditions are considered within the scheme.’

Image: julien Tromeur

More on this topic:

Life-changing research could quickly identify patients in need of vital liver transplant

Scientists reveal potential new approach to treating liver cancer


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