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Implementation notice: Lung policy modification for blood type

Implementation notice: Lung policy modification for blood type


  • All lung and heart-lung transplant programs 
  • OPTN Lung Transplantation Committee 
  • All OPTN representatives and alternative representatives 
  • All OPOs 

Implementation date 

Sept. 27, 2023


Effective today, the points assigned for blood type in lung allocation have been updated and are now as follows: 

  • Type O – 5 points 
  • Type B – 2.2382 points 
  • Type A – 0.3032 points 
  • Type AB – 0 points 

What you need to do 

Members should familiarize themselves with the new policy and update any professional and patient education materials accordingly. Transplant programs who have lung candidates with approved or pending exceptions to the biological disadvantages score are advised to review those candidates to assess if they are appropriately prioritized. If the exception is no longer needed, it can be withdrawn. Transplant programs may also submit new exception requests. 

Education and resources  

The following resources and education have been updated to reflect the changes of this policy change.  

In UNOS Connect: 

  • Lung Continuous Distribution Scoring and Exceptions 



See additional details in the policy notice.

Additional details

The three-month monitoring report of lung continuous distribution, which was implemented on March 9, 2023, revealed an unexpected decrease in the proportion of lung transplants performed for blood type O transplant recipients since implementation. This decrease was not consistent with the simulation modeling performed while the policy was in development. 

The OPTN Executive Committee approved submitting a policy proposal for a special public comment period that was open from Aug. 24 through Sept. 7. All comments were reviewed and considered by the OPTN Lung Transplantation Committee before developing a final proposal for the OPTN Board of Directors. The Board approved the policy on Sept. 22, 2023.  


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.

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