MELD Score: Liver Cancer and Other Exception Points

If you are looking for your MELD Score: Liver Cancer and other exception points, you’ve come to the right place. I ended up getting the extra points for liver cancer. If you have a situation where there are Extra Circumstances, you may get bonus points, or exception points too.

In my case, they found a tumor that was Hepatocellular Carcinoma or HCC. It was 2014 and the rules allowed me to bump up 22 points. The rules for exception points changed soon after that to 28 BUT the patient had to wait 6 months. That is where it stands currently. Keep reading to learn more about exception points. 

What are Exception Points?

Since the MELD score is made up of points for how sick your liver is, there are some cases where extra points are needed. Exception points are used in the liver transplant allocation process. The points aim to prioritize patients whose medical conditions may not be fully reflected by their MELD scores. These points are taken care of by your transplant team. You do not need to do anything but take care of yourself and stay compliant with all the things your doctor asks you to do. 

These points are granted by regional review boards to ensure that patients with specific conditions or complications receive appropriate consideration for transplantation. Here are some common scenarios where exception points might be granted. 

List of Exception Point Qualifiers

  1. Hepatocellular Carcinoma (HCC):
    • Patients with liver cancer (HCC) that meets specific criteria of tumor size can receive exception points. They are then given higher priority for a transplant before the cancer progresses or spreads to other parts of the body. (That was me and I’m THANKFUL)
  1. Portopulmonary Hypertension:
    • Exception points may be given to patients with severe portopulmonary hypertension, a condition characterized by high blood pressure in the lungs due to liver disease.
  1. Hepatopulmonary Syndrome:
    • Patients with this condition, which causes low oxygen levels in the blood due to liver disease, may qualify for exception points.
  1. Familial Amyloid Polyneuropathy:
    • This is a rare inherited condition where abnormal protein deposits affect nerves and organs, including the liver. Exception points may be granted to affected patients.

More Exception Points

  1. Primary Hyperoxaluria:
    • A rare genetic disorder that can cause kidney failure and require liver transplantation; patients may receive exception points to prioritize their need for a transplant.
  1. Cholangiocarcinoma:
    • Patients with certain types of bile duct cancer may qualify for exception points if they meet specific criteria for transplant eligibility.
  1. Metabolic Liver Diseases:
    • Conditions such as certain enzyme deficiencies that lead to progressive liver disease and other systemic complications may warrant exception points.
  1. Recurrent Bacterial Cholangitis:
    • Patients with recurrent infections of the bile ducts, often due to biliary tract diseases, may receive exception points. That can put them higher on the list.
How to Get Exception Points

The best part of getting exception points is that it is taken care of for you. It involves the transplant team submitting a request to the regional review board. They take care of all the  detailed medical documentation and justification for the exception. The review board then evaluates the request and determines whether to grant the additional points. The point system aims to ensure that patients with life-threatening conditions that are not captured by the MELD score get more attention. It gives them timely access to liver transplantation. It is just what I needed as my cancer kept growing back.

Has your doctor mentioned exception points to you?

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