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How are donor lungs allocated to people who need a transplant?

It is important for lung transplant candidates to understand the process by which donated organs are allocated in the U.S.

The Organ Procurement and Transplantation Network (OPTN) is the nation's organ procurement, donation and transplantation system. UNOS is the non-profit organization that operates the OPTN under a contract with the federal government. OPTN and UNOS continuously evaluate new advances and research and then use this information to improve organ transplantation policies to best serve those people needing a transplant. All transplant programs and organ procurement organizations are OPTN/UNOS members and agree to follow OPTN policies.

The lung allocation system assigns an individualized lung allocation score (LAS) to every lung transplant candidate over the age of 12.

Being "placed on the list" means patients' names and certain medical information are entered into the national database overseen by UNOS. Donor lungs are allocated by UNOS and the regional organ procurement organization, Gift of Life Donor Program. Suitable donors have a compatible blood type and are approximately the same size. Since the list is based on medical urgency, someone’s place on the list may fluctuate with health changes and the addition or removal of other people on the waiting list. People may be listed for transplant in more than one area within a region or multiple regions.

One of the eligibility factors for lung transplant is overall physical health. People are encouraged to stay healthy while they wait. Until the time of transplant, people remain under the care of their local pulmonologist.
In 2005, the U.S. Organ Procurement and Transplantation Network (OPTN) and its non-profit funding agency, United Network for Organ Sharing (UNOS), changed the nation's method of allocating organs to transplant candidates. The new method, involving a scoring system to help determine position on the organ waiting list, replaced an older system allocating organs on a first-come first-serve basis.

Under the new lung allocation system, every lung transplant candidate age 12 and older receives an individualized lung allocation score. The lung allocation score reflects both the seriousness of each candidate's medical status before transplant and the likelihood of a successful transplant. It is an important factor in determining priority for receiving a lung transplant when a donor lung becomes available. The system determines the order of all individuals awaiting a lung transplant by their lung allocation scores, blood type, and the geographic distance between the candidates and the hospital where the lung donor is located. Age also plays a role because lungs from pediatric and adolescent donors are now offered first to pediatric and adolescent candidates before they are offered to adults.

The score utilizes a complex clinical calculator derived from clinical predictors of survival that is reported on a scale of 0 to 100 (0 is least ill and 100 is the most ill). In the first year the new system was in place, over half of lung transplants were performed in patients with scores less than or equal to 40. Additional information on transplants performed each year is available through the published reports at the OPTN website.

OPTN maintains a centralized computer network linking all transplant centers and regional organ procurement organizations (OPOs), which identify potential organs for transplant and coordinate with the national network. This computer system is accessible 24 hours a day, seven days a week, with organ placement specialists available round the clock.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.