New lung data collection fields coming to support lung continuous distribution

Audience: (Please share this notice with anyone in your organization who would benefit from it.)

• Lung transplant programs
• Heart-lung transplant programs
• OPTN Lung Transplantation Committee
• OPTN Representatives and Alternate Representatives

Implementation date

Nov. 8, 2022

At-a-glance

Effective Nov. 8, two new lung data fields are being implemented in preparation for lung continuous distribution, which is to be released in January 2023.

The two new fields include:

• Prior living donor field
  • Will require documentation to be submitted to the Organ Center for lung candidates who previously donated an organ.
• On high flow nasal cannula field
  • Will display when the candidate requires supplemental oxygen at rest, at night or with exercise.
  • This field will become required for all lung candidates receiving supplemental oxygen at rest, at night or with exercise when lung continuous distribution is implemented in early 2023.

A new report in Waitlist^SM titled the Lung Composite Allocation Score: 28 day report has been created to help support members in their compliance with OPTN Policy 10.3. A Lung Clinical Values That Must Be Updated Every 28 Days.

The report will also include a transition report section to assist you in identifying candidates that are missing a response for the new question regarding supplemental oxygen delivery via a high-flow nasal cannula.

What you need to do

Transplant hospitals

For each candidate that requires supplemental oxygen at rest, with exercise or at night:

• Update the candidate record to indicate whether the oxygen is delivered via a high flow nasal cannula.
• Utilize the new Lung Composite Allocation Score: 28 day report in Waitlist to monitor and update clinical values for candidates meeting the frequent reporting criteria.

If your candidate has donated an organ for transplantation within the U.S. or its territories, they are eligible for additional points under lung continuous distribution allocation. The candidate’s physician will need to report all of the following information to the OPTN using the form available in UNet^SM Resources, Forms/Tools:

a) the name of the recipient or intended recipient of the donated organ or organ segment,
b) the recipient’s or intended recipient’s transplant hospital, and
c) the date the donated organ was procured.

Additional details

This data collection is in preparation for the implementation of lung continuous distribution in early 2023. There will be no impact to the candidate’s lung allocation score (LAS) at this time.

Reporting prior living donor status prior to implementation of allocation changes will allow your candidate to receive five attribute points in the Patient Access goal on implementation day of lung continuous distribution.

Candidates on continuous mechanical ventilation, ECMO or receiving supplemental oxygen via a high flow nasal cannula will meet the criteria outlined in the approved OPTN Policy 10.3.A. When a candidate meets the criteria, the values for supplemental oxygen and assisted ventilation must be updated every 28 days. If the values are not updated on the 28 day interval, the policy default values specified in OPTN policy will be used in the calculation of the candidate’s lung composite allocation score (CAS).

Education and resources

For further details, please refer to the notice of approved action to Establish Continuous Distribution of Lungs.

Professional education on this policy change is available in the OPTN learning management system known as UNOS Connect:

• Lung Continuous Distribution Playlist
  •  LUN 102 Basic Principles of Lung Continuous Distribution
  • LUN 103 Unacceptable Antigens & CPRA in Lung Continuous Distribution
  • LUN 104 Scoring and Exceptions Under Lung Continuous Distribution
  • SYS 183 Using the Lung CAS Report (see below reference to access report)

Lung transplant programs can access a program-specific composite allocation score (CAS) resource report in the Data Services Portal within UNet. Please access the Lung CAS Report for your transplant program in the Data Files section in the Data Portal.

To view your program’s candidate report in a national perspective, a set of CAS summary reference statistics are available on the UNOS website.

Questions
If you have questions relating to implementation, contact UNOS Customer Service at [email protected], or call 800-978-4334 from 8 a.m. to 7 p.m. ET.

For policy-related questions, contact [email protected].

The Organ Center is available 24 hours a day at 800-292-9537.