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Lung transplant rate increases by 16 percent one year after continuous distribution policy is implemented

Published on: Wednesday, May 29, 2024

A new data monitoring report evaluates key metrics one year after the implementation of the current lung allocation system, which was implemented March 9, 2023, by the Organ Procurement and Transplantation Network (OPTN). Lung is the first organ type to adopt the flexible and patient-centric system known as continuous distribution.

Since implementation, the lung transplant rate has increased by 16 percent (281 transplants per 100 patient years pre-policy vs. 327 transplants per 100 patient years post-policy1). There has also been a 29 percent decrease in the waiting list mortality rate (24 removals for death or too sick per 100 patient years in the pre-policy era vs. 17 removals for death or too sick per 100 patient years in the post-policy era).

Other key points:

  • The most medically urgent patients (those with 2.5 or more medical urgency points) had the highest transplant rates and the shortest median waiting time for a transplant
  • The utilization rate remained stable (17.0 percent in the pre-policy era vs. 17.5 percent in the post-policy era)
  • Median distance from the donor hospital to transplant program increased from 192 nautical miles in the pre-policy era to 385 nautical miles in the post-policy era
  • Before the blood type modification was implemented in September 2023, the transplant rate for candidates with blood type O was 218 transplants per 100 patient years. After the blood type rating scale modification, the transplant rate increased to 263 transplants per 100 patient years (a rate similar to the pre-policy era). Find more information on the blood type OPTN policy modification here

The report was presented to the OPTN Lung Transplantation Committee on May 9, 2024.  Subsequent monitoring reports will be published on the OPTN website annually for the next two years as outlined in the briefing paper. The Lung Committee will continue to monitor this policy to understand whether the changes are meeting intended goals.

1 Patient years is a type of measurement that takes into account both the number of patients that experience an event (receiving a transplant or being removed from the waiting list due to death or too sick to be transplanted) and the amount of time patients spend waiting for an event. For example, if 100 patients waited for one full year and 85 were transplanted, the transplant rate would be 85 transplants per 100 patient years. For a subject like transplant, time waiting is sometimes just as important as the event itself. For more information on this type of measurement, see the “Methods” section of the OPTN monitoring report.