Intended audience: recipient coordinator transplant program admin

Liver recipients may be required to participate in an Alcohol-Associated Liver Disease (ALD) program before they are included in a liver allocation and offer.

The recipient’s liver journey must be paused while they are in the ALD program.

After the recipient leaves the ALD program, update their journey to reflect the outcomes of their participation in the program – the journey could resume, be terminated, or be paused for other reasons.

Note: The ALD Program Participation does not apply to paediatric liver recipients (<18 years). If a liver journey was created while the recipient was paediatric, the ALD Program Participation section will not be displayed, regardless of the recipient’s current age.

Pausing a liver journey for ALD program participation

Pause the recipient’s liver transplant journey while they are in an ALD program.

The approach to pausing the journey differs depending on the phase the journey is in.

Phase

How to pause the liver transplant journey

Referral

Set a Referral Decision of Referral deferred.
See Manage referral decisions for details.

Consultation

Set a Consultation Decision of Consultation delayed and a Reason of Abstinence from Substance.
See Manage consultation decisions for details.

Medical Assessment

Set a Medical Assessment Decision of Further treatment/testing required and a Reason of Alcohol treatment (ALD).
See Manage medical assessment decisions for details.

Waitlist

Place a medical hold: set a Medical status of 0 and a Reason for Medical Hold of ALD Related.
See Manage a medical hold for details.

Adding ALD information

Once the journey is paused, record when the recipient enters and leaves their ALD program.

  1. Go to the recipient’s profile, select Liver and then select ALD Program Participation from the left side panel OR Scroll to the ALD Program Participation section.

    2. image-20260223-214844.png

  2. Select the Create ALD Program button.

  3. Enter required information in the New ALD Program fields:

    • Provide an ALD Status Date.

    • Select a Journey Phase from the dropdown.

      • image-20260223-215944.png

    • Select the ALD Status from the dropdown. 

      • image-20260223-220118.png

    4. Note: The ALD Status field will also provide an option of ‘No Longer Participating’ when there is at least one entry in the ‘ALD Program Participation’ table. You must select ALD Status of ‘No Longer Participating’ when a liver recipient exits the ALD Program.  

  4. Select the Save ALD Program Participation button.

    • To cancel, select the return to previous page icon or browse to any other page without saving. Any unsaved information is discarded.

The system determines the Journey Phase Decision and updates automatically upon saving the ALD Program Participation data. The new ALD program participation information will be displayed in the ALD Program Participation table.

Note: When journey phase ‘Pre-Referral’ is selected, the calculated Journey Phase Decision field remains blank.

Viewing and editing historical ALD information

You can edit the most recent entry in the ALD Program Participation table, unless the organ journey is declined or cancelled. All previous entries are displayed in the table and are read-only.

  1. Go to the recipient’s profile, select Liver and then select ALD Program Participation from the left side panel OR Scroll to the ALD Program Participation section.

  2. Select any entry from the table of historical test results to see its details in the Selected ALD Program fields.

  3. If this is the most recent entry, edit the information as required.

  4. Select the Save ALD Program Participation button.

    • To cancel, select the return to previous page icon or browse to any other page without saving. Any unsaved information is discarded


The system updates the selected entry in the ALD Program Participation table.

Updating a liver journey after ALD program participation

When the recipient completes their ALD program, restart or terminate their journey based on whether they were successful.

The way you restart or terminate the journey depends on the phase the journey is in.

If the recipient’s ALD participation was unsuccessful, but they are trying ALD again, leave the journey on pause and add a new ALD program to the ALD Program Participation table under Liver Specific Details.

Phase

Successful ALD participation, and proceeding with transplantation

Unsuccessful ALD participation, and no longer proceeding with transplantation

Referral

Set a Referral Decision of Referral accepted.

Set a Referral Decision of Referral declined.

Consultation

Set a Consultation Decision of Consultation completed.

Set a Consultation Decision of Consultation cancelled.

Medical Assessment

Set a Medical Assessment Decision of Recipient to be listed.

Set a Medical Assessment Decision of Recipient not eligible for transplant.

  • Select a Reason of Recipient does not meet listing criteria.

  • Select an Absolute Contradiction and/or Relative Contradiction from the drop downs.

Waitlist

Remove the ALD-related Medical Hold to return to active waitlist status.

  • Select the active Medical Hold from the Waitlist history table.

  • Select the Remove Hold option.

  • Select a new Medical Status.

Remove the recipient from the waitlist.

  • Select a Reason for Waitlist Removal.

See related topics