SUMMARY Background:The model for end stage liver disease (MELD)-based organ allocation system is designed to prioritize orthotopic liver transplantation (OLT) for patients with the most severe liver disease. However, there are no published data to confirm whether this goal has been achieved or whether the policy has affected long-term post-OLT survival. Aim: To compare pre-OLT liver disease severity and long-term (1 year) post-OLT survival between the preand post-MELD eras. Methods: Using the United Network of Organ Sharing database, we compared two cohorts of adult patients undergoing cadaveric liver transplant in the pre-MELD (n ¼ 3857) and post-MELD (n ¼ 4245) eras. We created multivariable models to determine differences in:

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