
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
For patients
Understand OPTN lung policy changes
- Lung patient brochure
- Narrated animated video explaining the lung CAS
- Patient webinar recording (in the patient section)
How will patients benefit?
Simulation modeling suggests that the new policy is likely to improve key measures of the lung transplant system, including:
- Reducing patient deaths on the waiting list
- Increasing transplant rates for the sickest candidates
- Decreasing geographic variability in transplant rates
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.
Lung and heart news
Lung CAS summary data updated
Information for lung transplant program physicians, surgeons, transplant coordinators, program directors and data coordinators on the distribution of scores for all active registrations waiting for lung transplants in the U.S.
Pediatric Status 1A and 1B heart and heart-lung candidates may have expanded access to intended incompatible blood type offers
On March 16, 2023, the OPTN Executive Committee approved immediate implementation of a key portion of. the recently proposed policy to expand eligibility criteria.
New lung allocation policy in effect
First organ type to use continuous distribution framework.
Implementation notice: Continuous distribution of lungs
Effective today (March 9), lungs are now allocated under the approved continuous distribution allocation policy.
What happened in public comment? See what the community had to say. View comments
Essential reading and resources

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
New lung policy took effect March 9, 2023
- 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