Adult National Offering Scheme for Adult Deceased Donors to Adult Recipients

DBD DCD

Super Urgent

Hepatoblastoma

Multi-organ (Liver +Small bowel)

Suitable for Split

Yes

No

LLS or left lobe offered for suitable paed/small adult

Accepted

Right lobe through agreed offering sequence

Declined

Super Urgent

NSHBT generate an offering sequence

National Liver Offering Sequence

Full offer to centre with patient ranked 1(45 mins)

AcceptedStop offering

Declined check if centre would consider for any patient if no the centre will receive no further offers

Full offer to centre with patient ranked 2 (45mins)

Stop offering and withdraw provisional offer

Accepted

Provisional offer to centre with patient ranked 3

Full offer to centre with patient ranked 3 (30 mins)

Declined:check if centre would consider for any patient if no the centre will receive no further offers

Accepted Stop offering and withdraw provisional offer

Provisional offer to centre with patient ranked 4

Full offer to centre with patient ranked 4 (30 mins)

Stop offering and withdraw provisional offer

Accepted

Provisional offer to centre with patient ranked 5

Full offer to centre with patient ranked 5 (30 mins)

Accepted Stop offering and withdraw provisional offer

This offering sequence continues until the liver has been declined for the first 10 patients on the offering sequence, the liver has been declined for the same reason on the basis of the same donor characteristic category by three transplant centres or retrieval has commenced after which time the liver is fast tracked.

Declined:check if centre would consider for any patient if no the centre will receive no further offers

Declined:check if centre would consider for any patient if no the centre will receive no further offers

Declined: check if centre would consider for any patient if no the centre will receive no further offers

Liver offered to all centres simultaneously (unless previously declined for all recipients)

Declined for all recipient

Names of suitable recipients given to the duty office by the transplant centre with 30 minutes

The Liver is allocated by duty office to the patient who is furthest up the previously defined offering sequence

Duty office inform those liver transplant centres who put names forward of the fast track outcome

Fast Track offering