New OPTN/UNOS policy for liver transplant allocation: Standardization of liver imaging, diagnosis, classification, and reporting of hepatocellular carcinoma

A new liver allocation policy featuring improved imaging criteria for HCC exceptions has been developed and approved by OPTN/UNOS in late 2011. Included are minimum technical and protocol requirements for CT and MR imaging, diagnostic and classification criteria for HCC, and standardized reporting requirements. The intent is to improve the accuracy of radiologic diagnosis and staging of HCC, qualifying patients for automatic MELD exception points on the LT waiting list and in the absence of liver biopsy. Radiologists in accredited transplantation centers in the United States are now challenged to implement the policy.