Organ distribution
Lung policy
Making allocation more fair and flexible
Making lung distribution fair and equitable
In its continued drive toward increasing equity, the donation and transplant community has developed a more fair and flexible lung allocation system. On March 9, 2023, new policies replaced the previous lung allocation system.
Lungs are the first organ type to be allocated under this new framework, called continuous distribution. In continuous distribution of lungs, candidates will receive a composite allocation score, which means no single factor will determine a lung patient’s priority. Watch explanatory videos
Lung and heart news
Lung CAS summary data updated
Information for lung transplant programs on the distribution of scores for all active registrations waiting for lung transplants in the U.S.
Implementation notice: Standardize six-minute walk for lung allocation
New policy requirement in effect that requires lung transplant programs to perform an oxygen titration test ahead of initial the six-minute walk test.
Pre-implementation notice: Standardize six-minute walk for lung allocation
A new policy requirement is going in effect that will require lung transplant programs to perform an oxygen titration test ahead of the initial six-minute walk test.
How are patients benefiting?
Since implementation*,
- There has been a 26.1% decrease in candidates removed from the waiting list due to death or too sick to transplant
- No negative impact on lung utilization
- The most medically urgent patients have the shortest wait times to get transplanted compared to the rest of the candidates on the waiting list
*Source: Six-month lung continuous distribution monitoring report (Reporting period 9/6/22 to 9/8/23)
How did the community develop this policy?
The community was able to participate in the development of the policy through several public comment periods and online interactive values exercises. The methodology behind the exercises was a new way to collect community input early in the process.
Patients benefit from a more efficient system that gets the right organ to the right patient, at the right time.
The Board of Directors considered the community’s feedback and unanimously approved the policy in December 2021.
Learn more about the steps the Lung Committee followed to build the framework.
What happened in public comment? See what the community had to say. View comments
Essential reading and resources
Lung transplant rates continue to increase six months post implementation of new lung policy
Lung-alone transplants have increased by 11.2 percent.
Lung continuous distribution policy now in effect
Implemented lung policy is projected to decrease deaths among waitlisted patients and provide more transplants for the most medically urgent candidates.
What is Composite Allocation Score (CAS)?
Answers to the most common questions from people seeking a lung transplant for themselves or a loved one.
How is policy changing?
Learn how the community is developing continuous distribution, a more equitable system of allocating deceased donor organs.
Building a new, more flexible system for organ allocation
How multi-criteria decision-making methodologies and big data analytics are helping to design continuous distribution policies
For patients
- Lung patient brochure: English | Español
- Narrated animated video explaining the lung CAS
- Patient webinar recording (in the patient section)
- Information about transplant
For professionals
- UNOS Connect for professional education
- OPTN toolkit for patients and professionals
- Toolkits: allocation calculators, policy and guidance, patient education
- Lung allocation system on OPTN
- Lung OPTN committee