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Revise Lung Review Board Guidelines, Guidance, and Policy for Continuous Distribution

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Continuous distribution is a new system to allocate lungs that will be implemented in 2023. This system includes a Lung Review Board to evaluate exception requests for the different components of the composite allocation score. The operational and clinical guidelines for this review board and for transplant programs are not currently outlined in policy.

Supporting media


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Proposed changes

  • Establish operational guidelines to outline the representation, responsibilities, and process for the review board
  • Provide clinical guidance for what information programs should provide when submitting a request
  • Provide guidance for review boards to consider when evaluating requests
  • Update policy to provide more consistency across organ types

Anticipated impact

  • What it's expected to do
    • Help make sure exception requests contain appropriate, relevant clinical information
    • Help make sure review board members evaluate exception requests with consistency
    • Continue efforts to standardize review boards across organ types
  • What it won't do
    • Create policy criteria for review board members to use when evaluating exception requests

Terms to know

  • Exception Request: When a transplant program believes that one of the parts of a candidate’s calculated composite allocation score does not accurately reflect the candidate’s condition, it may submit a request for a different score.
  • Composite Allocation Score: The total number of points assigned to a candidate on the waiting list, which determines the candidate’s place on a match run.

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