title: The equitable allocation of deceased donor lungs for transplant in children in the United States.
abstract: On June 5, 2013, a US Federal Court ordered a temporary restraining order to allow two children within the court's jurisdiction to be registered on the adolescent lung transplant waiting list. On June 10, 2013, the Organ Procurement and Transplantation Network's Executive Committee altered lung allocation policy to offer candidates aged younger than 12 years greater access to adult lungs at the discretion of the national Lung Review Board. The Scientific Registry of Transplant Recipients reviewed trends over time in deceased donor lung transplant waitlist mortality and transplant rates, comparing children and adults. Mortality rates of candidates active on the waiting list have been higher for children aged 0-5 years, but have not differed for children aged 6-11 years compared with adolescents aged 12-17 years or adults aged 18 years or older. Transplant rates among active waitlist candidates have been comparable across all age groups. Thus, there is little evidence that the allocation system led to differences in waitlist mortality or transplant rates for children compared with adults. However, these comparisons are difficult to interpret given that current policies likely led to unaccounted differences in the severity of illness at the time of listing.
authors: The Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors: J J
authors: JJ
authors: Snyder
authors: N
authors: N
authors: Salkowski
authors: M
authors: M
authors: Skeans
authors: T
authors: T
authors: Leighton
authors: M
authors: M
authors: Valapour
authors: A K
authors: AK
authors: Israni
authors: M I
authors: MI
authors: Hertz
authors: B L
authors: BL
authors: Kasiske
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D040841:Resource Allocation / Q000331:legislation & jurisprudence*; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014481:United States; D014850:Waiting Lists / Q000401:mortality*
keywords: Adolescents; lung allocation score; mortality; waiting list