Liver allocation policy in the United States changed on February 4, 2020 1,2 . Acuity circles replaced donation service areas (DSAs) as the geographic determinant in allocation and broad sharing replaced a predominantly local distribution system. 3 Lawsuits 4 filed by waitlisted transplant candidates argued that probability of receiving a transplant should not depend on DSA boundaries and litigation drove national policy change. In liver transplantation, differences in median MELD score at transplant (MMaT) between centers came

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