Perspectives on donor lung allocation from both sides of the Atlantic: The United States.

Journal Article (Journal Article)

Donor lung allocation in the United States focuses on decreasing waitlist mortality and improving recipient outcomes. The implementation of allocation policy to match deceased donor lungs to waitlisted patients occurs through a unique partnership between government and private organizations, namely the Organ Procurement and Transplantation Network under the Department of Health and Human Services and the United Network for Organ Sharing. In 2005, the donor lung allocation algorithm shifted toward the prioritization of medical urgency of waitlisted patients instead of time accrued on the waitlist. This led to the Lung Allocation Score, which weighs over a dozen clinical variables to predict a 1-year estimate of survival benefit, and is used to prioritize waitlisted patients. In 2017, the use of local allocation boundaries was eliminated in favor of a 250 nautical mile radius from the donor hospital as the first unit of distance used in allocation. The next upcoming iteration of donor allocation policy is expected to use a continuous distribution algorithm where all geographic boundaries are eliminated. There are additional opportunities to improve donor lung allocation, such as for patients with high antibody titers with access to a limited number of donors.

Full Text

Duke Authors

Cited Authors

  • Tsuang, WM; Snyder, LD; Budev, MM

Published Date

  • July 2020

Published In

Volume / Issue

  • 34 / 7

Start / End Page

  • e13873 -

PubMed ID

  • 32274840

Pubmed Central ID

  • PMC7544657

Electronic International Standard Serial Number (EISSN)

  • 1399-0012

International Standard Serial Number (ISSN)

  • 0902-0063

Digital Object Identifier (DOI)

  • 10.1111/ctr.13873

Language

  • eng