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Lung Allocation

What is the lung allocation system?

In the lung allocation system, every lung transplant candidate age 12 and older will receive an individualized lung allocation score. The lung allocation score is an important factor in determining priority for receiving a lung transplant when a donor lung becomes available. The system will determine the order of everyone awaiting a lung transplant by their lung allocation scores, blood type, and the geographic distance between the candidates and the hospital where the lung donor is located. Age will also play a role because lungs from pediatric and adolescent donors will be offered first to pediatric and adolescent transplant candidates before they are offered to adults.

The lung allocation system uses medical information specific to each lung transplant candidate. This information includes lab values, test results, and disease diagnosis. This medical information is used to calculate a lung allocation represents an estimate of the severity of each candidate's illness and his or her chance of success following a lung transplant. All candidates will be placed in order for compatible lung offers according to their score: A candidate with a higher lung allocation score will receive higher priority for a lung offer when a compatible lung becomes available.

The supply of donor lungs is limited. The OPTN designed this allocation system to more effectively use the limited number of available donor lungs as well as reduce the number of deaths among people waiting for a transplant. Prior to this system, transplant candidates received donor lungs based on the amount of time they had been on the waitlist for transplantation. The OPTN designed the lung allocation score system by studying scientific data on lung transplantation and by drawing on prior experience with many types of patients with lung diseases. By offering donor lungs to candidates according to their medical characteristics instead of their waiting time, lungs will be directed first to candidates who have the most urgent need and who will have the greatest chance of success after transplantation.

What does the lung allocation system mean for me?

The lung allocation system is responsive to your individual medical needs because it will help determine when you will receive an offer for donor lungs based on your particular medical information. Your lung allocation score is based on your own medical information and will reflect the seriousness of your medical status before transplant and your likelihood of a successful transplant.

How is waiting time used in the lung allocation system?

Waiting time plays a very limited role when allocating lungs to transplant candidates ages 12 and older. These candidates will receive lung offers based mainly on their lung allocation scores. Waiting time will be used only to break a tie if two lung candidates happen to have the same lung allocation score.

Waiting time plays a more significant role in the system for transplant candidates under age 12. These candidates will receive offers based on the amount of time they have waited for a lung transplant, their blood type, and distance from the donor hospital.

How do I register as a lung transplant candidate under the lung allocation system?

Your transplant team will decide with you when the time is right for you to be registered for a lung transplant. When that time comes, you will need a complete transplant work-up. During the transplant work-up, you will participate in a series of medical tests that will give your transplant center the information it needs to register you as a candidate for lung transplantation. This same information will also be used to calculate your lung allocation score.

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