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Continuous distribution of lungs concept paper

Proposal Overview

Status: Public Comment

Sponsoring Committee: Thoracic Organ Transplantation Committee

Strategic Goal: Provide equity in access to transplants

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Read the concept paper (PDF; 8/2019)

Contact: Betsy Gans

eye iconAt a glance

You may be interested in this concept if

  • You work for a transplant program
  • You work for an OPO
  • You are a transplant candidate or a family member of a transplant candidate

Here’s the purpose of this document

In December 2018 the OPTN Board of Directors approved the continuous distribution framework for all organ allocation systems. Continuous distribution will prioritize waiting list candidates based on a combination of points awarded for factors related to medical severity, expected post-transplant outcome, the efficient management of organ placement, and equity. Continuous distribution will eliminate hard boundaries, which currently preclude a patient from being prioritized ahead of patients on the other side of the boundary.

Why this may matter to you

This model will eliminate hard boundaries and classifications that many people are accustomed to. It will also enable dynamic multi-factor allocation policies.

Tell us what you think

  • Do you understand the advantages of a points-based system versus the current classification-based system?
  • Are there other measures of the efficient management of organ placement that should be taken into account in a points-based framework?
  • What other issues should be considered to convert other organ systems to a points-based framework?
  • What factors should be incorporated into the allocation of lungs within a continuous distribution framework?


Anonymous | 08/06/2019

as a candidate for almost 3years i feel i hwait longer than the average person due to COPD that should not be a factor.....I have the same issues as all others on the wait list yet the pecking order puts copd at the bottom....I also had lvrs which is not even allowedd to be put into that equasion. very frustrating to say the least

Mark Rolfe | 08/17/2019

This is a very reasonable proposal and would better allocate organs than the current "zone model". The only cautionary point I would offer is the weight of "efficiency" of organ placement in the total calculation not be based on financial concerns. The "cost" of driving across town to acquire an organ should not be an issue/ adjustment that would give preference to a "local recipient" over a recipient where the organ acquisition team is required to helicopter or fly in to acquire the organ, if all other outcome indicators are equal. The continuous distribution of organs scores should be based on need and predicted outcomes and not on financial considerations for the transplant center, the donor center or the OPOs. How much is a life is worth, or how much profit a center, or OPO can make is an area where no one should see this organization attempting to make adjustment in a new allocation system.