PURPOSE The aim of this paper is to summarize the allocation challenges facing the field of liver transplantation while providing examples of the expansion of indications for the procedure. METHODS UNOS allocation policy was reviewed as well as the recent literature describing expanded criteria for recipient candidate selection. RESULTS Liver allocation policy changes for deceased-donor organs remain gridlocked in legal and bureaucratic red tape. Meanwhile, the indications for liver transplantation are being expanded to include acute alcoholic hepatitis, intrahepatic cholangiocarcinoma, and colorectal metastasis, previously viewed as absolute contraindications, but under strict selection criteria. CONCLUSIONS Attempting to meet the demand for livers, transplant centers are increasingly turning to living donor liver transplantation, protocols such as HCV-positive to HCV-negative transplants, and machine perfusion of marginal organs.

中文翻译：

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肝移植：当前和未来。

目的本文的目的是总结肝移植领域面临的分配挑战，同时提供扩大该手术适应症的实例。方法回顾了UNOS的分配政策以及描述扩展候选候选人选择标准的最新文献。结果死者捐献器官的肝脏分配政策变化仍然陷入法律和官僚繁文tape节中。同时，肝移植的适应症正在扩大，包括急性酒精性肝炎，肝内胆管癌和结直肠转移，以前被视为绝对禁忌症，但要严格选择标准。结论为了满足对肝脏的需求，移植中心越来越多地转向活体供肝移植，