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Executive committee approves discretionary listing of pediatric lung transplant candidates

Published on: Tuesday, June 10, 2014

Richmond, Va. - The OPTN/UNOS Executive Committee, meeting by conference call, approved a revision to national lung allocation policy affecting transplant candidates age 11 or younger. The revised policy provides a mechanism for lung transplant programs to request additional priority for these candidates, for whom the transplant team would consider transplanting lungs from an adolescent or adult donor.

The policy allows a lung transplant program to submit a request to a national lung review board for a candidate age 11 or younger to have an additional listing, at the same hospital, indicating that he or she should be considered for offers from adult and adolescent donors based on the existing Lung Allocation Score for adolescent and adult candidates. The pediatric candidate would also retain his or her priority for pediatric donors, which includes immediate access to matching donors within a 1000-mile radius of the donor hospital.

While this policy is effective immediately, it will expire on July 1, 2014, pending reconsideration by the full OPTN/UNOS Board of Directors and additional study and recommendations from OPTN/UNOS committees regarding the measures and outcomes of pediatric lung allocation policy. The number of patients potentially affected by this policy is very small and unlikely to have a significant impact on the larger pool of transplant candidates.

The Executive Committee considered public input as well as recommendations from the OPTN/UNOS Ethics, Pediatric Transplantation and Thoracic Transplantation Committees in its consideration of the new policy.

As of June 10, 2013, 1,659 candidates were listed for a lung transplant nationwide, of whom 30 are age 10 or younger. The lung transplant program treating a candidate always makes an individual medical decision whether to accept any lung offer for that person, including the possibility of using lungs from an adolescent or adult donor for a pediatric candidate.

It is not immediately known how many candidates may be considered for this option. According to OPTN data, only one lung transplant in the United States has occurred from a donor older than age 18 into a recipient younger than 12 since 2007.