Heart & lung
On March 9, 2023, a new lung allocation policy based on continuous distribution was implemented. Member education and resources are available in the implementation toolkit to help you understand the new policy.
Policy toolkits
Allocation calculators
Lung Composite Allocation Score (CAS) calculator
A guide to calculating the lung composite allocation score (Lung CAS) (last updated 11/15/23)
Monitoring reports
- Five-Year Monitoring Report: Heart Allocation Proposal to Modify the Heart Allocation System (PDF 04/2024)
- One-Year Monitoring Report: Amend Adult Heart Status Extension Requirements (PDF 03/2024)
- Two-Year Monitoring Report: Pediatric National Heart Review Board (PDF 12/2023)
- One-Year Monitoring Report: Heart Policy to Address Patient Safety Following Device Recall (PDF 12/2023)
- Four-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF 3/2023)
- One-year heart monitoring report: Pediatric National Heart Review Board (PDF 12/2022)
- Six-month heart monitoring report: Heart policy to address patient safety following device recall (PDF 04/2023)
- Three-month heart monitoring report: Heart policy to address patient safety following device recall (PDF 11/2022)
- Three-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF 9/2022)
- Two-year heart monitoring report: Eliminate the use of DSAs in thoracic allocation (PDF 8/2022)
- One-year heart monitoring report: Eliminate the use of DSAs in thoracic allocation (PDF 7/2020)
- Two-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF 3/2021)
- One-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF 3/2020)
- Two-year monitoring report: Lung continuous distribution (PDF 5/2025)
- 18-month monitoring report: Lung continuous distribution (PDF 12/2024)
- One-year monitoring report: Lung continuous distribution (PDF 5/2024)
- Three-month monitoring report: Lung CD-Blood type rating scale modification (PDF 2/2024)
- Six-month monitoring report: Lung continuous distribution (PDF 10/2023)
- Three-month monitoring report: Lung continuous distribution (PDF 7/2023)
- Nine-month monitoring report available for lower respiratory testing of lung donors (8/2021)
- Two-year monitoring report on removal of DSA from lung allocation(PDF 2/2020)
Policy & guidance
Heart
- FDA MDR Reporting Requirements (04/2024)
- FDA Regulation of Allograft Heart Valves OPTN Operations and Safety Committee Meeting (4/2024)
- OPTN policy 6: allocation of hearts and heart-lungs (PDF - 2.5 M; 2/2022 )
- Evaluation plan guidance for policy 6 (PDF - 91 K; 7/2021)
- Adult heart allocation toolkit
- National Heart Review Board (NHRB) for Pediatrics FAQ (PDF - 900KB; 7/2021)
- Guidance for Adult Heart Exception Requests (Status 2 Cardiogenic Shock Candidates) (PDF - 448KB; 2/2021)
- Guidance for Pediatric Heart Exception Requests (PDF - 189 KB; 6/2025)
- Heart Allocation Variances (None active as of 3/1/2020) (PDF 378 K)
- Review board guidance for HCM/RCM exception requests (PDF - 674 K; 10/2018) Effective 10/18/2018
- Review board guidance for adult CHD exception requests (PDF - 180 K; 12/2017)
Lung
- Guidance for Conducting the Six-Minute Walk Test for Lung Allocation (09/2024)
- FDA MDR Reporting Requirements (04/2024)
- OPTN policy 10: allocation of lungs (PDF - 2.5 M; 2/2022)
- Evaluation plan guidance for policy 10 (PDF - 91 K; 7/2021)