Richmond, Va. – The OPTN/UNOS Board of Directors, at its meeting December 1 and 2, approved amendments to lung allocation policy to provide more opportunities for candidates younger than 18 years of age to receive transplants from donors who are also younger than 18. Simulation modeling suggests that the newly approved policy will increase transplant rates for children, especially those between the ages of 6 and 11, without significantly affecting adult candidates.
“This policy improvement should help a group of patients whose need is particularly great,” said OPTN/UNOS President Betsy Walsh, J.D., M.P.H. “While there are few very young lung transplant candidates, the best opportunity they have for a transplant is from a donor of similar age and body size. This approach will broaden their access to lifesaving care.”
The policy will provide broader geographic sharing of lungs from all donors younger than age 18 first to medically compatible candidates who are newborn to age 11, then to adolescents age 12 to 17. Lungs not accepted for these candidates will then be offered to adult candidates.
The revised policy also will allow lung candidates listed before they are two years old to be considered for donor lungs of any blood type, if their transplant program chooses to do so. This should allow greater access to transplantation because infants do not develop sensitivity to “incompatible” blood types until they are older than two, and because it is less common to locate lung donors younger than age two who are an identical blood type match with candidates.
In separate action, the Board established specific criteria for hospitals intending to perform kidney, liver or heart transplants for pediatric recipients (younger than age 18). The new requirements will apply whether the transplant hospital is a pediatric-only institution or whether it treats both adults and children. The criteria include training and experience requirements for at least one designated surgeon and one designated physician at each transplant program, to ensure they have expertise in treating pediatric candidates and recipients.
The Board also called for the formation of a working group to recommend improvements in clinically relevant measures used in public reporting of transplant outcomes at individual transplant hospitals.
Other actions approved at the Board meeting included:
- a revision to OPTN data release policies intended to broaden the public availability of data
- a reduction of requirements for paper documentation accompanying organs due to electronic availability of the same information
- an update to an existing white paper outlining ethical principles related to living, non-directed organ donation
- a modification to OPTN bylaws that will increase some OPTN committee member terms to three years
The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation, by United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop national organ transplantation policy.