@rosemarya and @jodeej,
HCC and exception points is always a difficult process to understand. When changes are made to the policy, UNOS doesn’t typically print a “patient friendly” version of those changes, so it’s important to check with your physician when you have questions regarding a change. When you brought up this discussion a few days ago, we actually had one of our physicians speaking to a group about these changes that very evening – what a coincidence! We were able to ask her for some clarification, and she said the biggest change is inclusion of the AFP blood test in the listing requirements for the patient. Previously, UNOS didn’t require the AFP level. Now the level must be below 1000ng/mL. If the level is above this, it must fall below 500ng/mL with treatment in order for the patient to be listed. While there are some other changes, this is the primary difference in the new policy. It also sounds like the Regional Review Boards will be reviewing cases more often than they have done in the past.

This is a link to the actual policy, in case you want to review any parts of this with your physician next time you visit with them.
https://optn.transplant.hrsa.gov/media/2411/modification-to-hcc-auto-approval-criteria_policy-notice.pdf