Lung transplant rules eased for children

At an emergency meeting held in response to a pair of lawsuits, the organization tasked with setting lung transplant allocation policies voted to allow children younger than 12 years old to apply for a lung from an adult donor.

An executive committee made up of members from the Organ Procurement and Transplantation Network and the United Network for Organ Sharing voted in favor of the policy revision during the emergency meeting late Monday night.

UNOS manages the Organ Procurement and Transplantation Network under a federal contract with HHS.

The revision, which is effective immediately, will allow the families of children in need of a lung transplant to request that the national lung review board allow them to apply for transplants from both adult and adolescent donors at the same hospital.

“The revised policy provides a mechanism for lung transplant programs to request additional priority for these candidates, for whom the transplant team would consider transplanting lungs from an adolescent or adult donor,” the executive committee said in a statement.

Two lawsuits, filed in federal court in Philadelphia, raised questions about the existing policy and led to the OPTN/UNOS's vote to revise the policy.

The families of 10-year-old Sarah Murnaghan and 11-year-old Javier Acosta filed lawsuits seeking to overturn organ transplant rules that prevented children younger than 12 years old from being listed on the adult transplant list. The families argued that the initial policy did not meet requirements set out by the National Organ Transplant Act.

A U.S. district judge last week granted temporary restraining orders that allowed Murnaghan and Acosta to be placed on the adult transplant list based on the severity of their conditions. Both children have cystic fibrosis.

“Now as a result of the OPTN's decision, transplant professionals will decide whether Sarah and Javier should be treated as if they were 12 for purposes of lung allocation,” Stephen Harvey, a partner at the law firm Pepper Hamilton, said in an e-mailed statement.

There are 30 children younger than 11 years old who are seeking lung transplants, according to OPTN data. Since 2007, there has been one lung transplant in a recipient younger than 12 who received a lung from an adult donor. About 1,600 adults are also waiting for lung transplants.

The revised policy is effective until July 1, 2014. During the next year, the board plans to conduct additional studies around the revised lung allocation policy and its impact on outcomes.

Harvey said in the statement that a hearing on the temporary restraining orders remains scheduled for Friday and he plans to ask HHS Secretary Kathleen Sebelius to keep the orders in place until the lung review board decides the children's cases.

Follow Jaimy Lee on Twitter: @MHjlee