In the US, and many other countries with substantial deceased donor programs, the liver transplant allocation systems based on the model for end-stage liver disease (MELD) score. MELD, a numerical calculation ranging from 6 to 40, allows for objective stratification of patient mortality by using laboratory values for bilirubin, international normalized ratio, and serum creatinine. More than 30% of patients receive additional priority due to MELD exception points. Although the MELD scoring system was intended to allocate organs to the sickest candidates, several distribution disparities have reduced the effectiveness of such a scoring system. With a new allocation system in place that uses distance from the donor hospital over arbitrarily designed geographic areas, statistical modeling has shown that fewer people in the US will die waiting for a liver, and that the geographic location of patients will be less important than how medically ill they are.