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18-month monitoring report available for lung continuous distribution policy

Published on: Monday, January 13, 2025

The Organ Procurement and Transplantation Network (OPTN) has released a data monitoring report for the past 18 months of lung allocation, which has been operating under a new framework called continuous distribution (CD).

Implemented on March 9, 2023, lung continuous distribution combines all factors used in an organ match into a single score for each lung transplant candidate. The framework is projected to increase lung transplants for the most medically urgent candidates and decrease deaths among patients waiting for a lifesaving transplant.

Shortly after lung CD was implemented, the OPTN implemented a change to the blood type rating scale on September 27, 2023 with the goal of improving access to lung transplants for blood type O candidates. This report compares metrics from before and after the implementation of CD, as well as after the blood type rating scale change was implemented.

Key points from the report include:

  • The overall waiting list mortality rate decreased after CD implementation
  • Blood type O transplant rates increased after the blood type modification was implemented
  • The waiting list mortality rate for pediatric candidates remained similar after CD was implemented
  • Less than 10 prior living donors were listed for a lung transplant after the implementation of CD and all these candidates were transplanted
  • There were no noticeable trends in waiting list mortality rates or transplant rates based on center size or geography
  • Six-month post-transplant patient survival was the same before and after CD implementation

The OPTN Lung Transplantation Committee specifically requested that the 18-month monitoring report focus on the following six topics: 1) overall implications, 2) blood type, 3) pediatrics, 4) prior living donors, 5) center size and geography, and 6) post-transplant patient survival. For updated data on other elements of lung transplantation, visit the OPTN Lung Policy Monitoring Dashboard.

Background

In 2019, the OPTN began work to adopt a single distribution framework that could be adapted to all organ types. This approach, known as continuous distribution, is a points-based system predicted to increase equity among potential recipients. Read more about the continuous distribution framework.