Recent media coverage has focused public attention on the needs of lung transplant candidates, especially those who are young children. Nearly 1,700 people nationwide await a life-saving lung transplant, including 30 children age 10 or younger. Unfortunately, due to the shortage of organ donors, many people must wait months or years for a transplant opportunity and some patients die without a transplant. Another 117,000 people are listed for other types of organ transplants.
United Network for Organ Sharing (UNOS) manages the national Organ Procurement and Transplantation Network (OPTN) under federal contract. The OPTN is charged with developing national policy to distribute available organs among all waiting list candidates. OPTN allocation policy is applied consistently to allow all candidates an equitable opportunity to receive a transplant, recognizing that their individual medical needs and circumstances will vary.
Every transplant begins with someone’s selfless commitment to save the lives of others through organ donation. While policy continues to be developed and refined to best meet the needs of all candidates, the public can help meet the needs of all who continue to wait by making and sharing a personal commitment to donation. For more information about registering to be a donor, please visit http://www.organdonor.gov/becomingdonor/stateregistries.html?gclid=CP_9pfP5s7cCFYiDQgodoXMAVA. You can also register and share your commitment through http://www.facebook.com/help/organ-donation.
The biological needs and circumstances of candidates younger than age 12 are different from either adolescent or adult candidates. One key difference is the size and lung capacity of donors and patients among these age ranges. For this reason, lung allocation policy differs for these groups of candidates and is designed to suit their unique needs. Children younger than age 12 have priority for all donors of similar age and size within a 1,000-mile radius before any older candidates would be considered. In some circumstances, a transplant center may determine that a child’s condition warrants a reduced size transplant from an adult donor. If the center wishes to consider this additional treatment option, these children will have access to adult organs once they are offered to adolescents and adults in the same allocation zone.
In 2012, there were 460 pediatric organ donors in the United States, including 114 between the ages of 6 and10 years. Although there were only 11 lung donors in that age group, that number likely reflects low demand (two lung transplants in recipients aged 6-10) as much as organ availability.
OPTN policies allow status adjustments for specifically defined groups of candidates with unique medical circumstances not addressed by the overall policy. A request to adjust the status of a patient under age 12 so that they may be included in the allocation sequence for adolescents and adults is not within the scope of the existing lung allocation policy.
OPTN cannot create a policy exemption on behalf of an individual patient, since giving an advantage to one patient may unduly disadvantage others. However, the network routinely reviews organ allocation policy to be sure that it reflects the needs of all groups of candidates. In this review process, the OPTN considers public input as well as medical data and experience.
While the availability of organs remains limited, the OPTN is committed to developing and improving policies that give all groups of candidates the best possible opportunity for life-saving transplantation.