ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2019
Unintended consequences of changes to lung allocation policy.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Article
- Activation of donor-derived eosinophils during static storage contributes to primary graft dysfunction after lung transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications.Clinical transplantation · 2025Article
- Impact of the Composite Allocation Score on Lung Transplant Waitlist and Posttransplant Outcomes.Transplantation direct · 2025Article
- Impact of lung allocation policy change on Hispanic lung transplant outcomes: Addressing disparities and improving access.JTCVS open · 2024Article
- Going the distance: Geographic effects of the lung transplant composite allocation score.JHLT open · 2024Article
- A Recruitment Maneuver After Apnea Testing Improves Oxygenation and Reduces Atelectasis in Organ Donors After Brain Death.Neurocritical care · 2024Article
- Development and validation of primary graft dysfunction predictive algorithm for lung transplant candidates.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Early national trends of lung allograft use during donation after circulatory death heart procurement in the United States.JTCVS open · 2023Article
- Same-teams versus different-teams for long distance lung procurement: A cost analysis.The Journal of thoracic and cardiovascular surgery · 2023Article
- Contemporary trends in PGD incidence, outcomes, and therapies.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2022Article
- Specialized Donor Care Facility Model and Advances in Management of Thoracic Organ Donors.The Annals of thoracic surgery · 2022Review
- Commentary: The cost of drawing the line: Lung transplant programs in the post-donor service area era.The Journal of thoracic and cardiovascular surgery · 2022Article
- Advanced considerations in organ donors.Journal of thoracic disease · 2021Review
- Lung transplantation using allografts with more than 8 hours of ischemic time: A single-institution experience.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2021Article
- Different-team procurements: A potential solution for the unintended consequences of change in lung allocation policy.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Donor management using a specialized donor care facility is associated with higher organ utilization from drug overdose donors.Clinical transplantation · 2021Article
- A revealed preference analysis to develop composite scores approximating lung allocation policy in the U.S.BMC medical informatics and decision making · 2021Article
- Economic evaluation of the specialized donor care facility for thoracic organ donor management.Journal of thoracic disease · 2020Article
- Perspectives on donor lung allocation from both sides of the Atlantic: The United States.Clinical transplantation · 2020Article
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18 authors.
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Abstract
Organ allocation for transplantation aims to balance the principles of justice and medical utility to optimally utilize a scarce resource. To address practical considerations, the United States is divided into 58 donor service areas (DSA), each constituting the first unit of allocation. In November 2017, in response to a lawsuit in New York, an emergency action change to lung allocation policy replaced the DSA level of allocation for donor lungs with a 250 nautical mile circle around the donor hospital. Similar policy changes are being implemented for other organs including heart and liver. Findings from a recent US Department of Health and Human Services report, supplemented with data from our institution, suggest that the emergency policy has not resulted in a change in the type of patients undergoing lung transplantation (LT) or early postoperative outcomes. However, there has been a significant decline in local LT, where donor and recipient are in the same DSA. With procurement teams having to travel greater distances, organ ischemic time has increased and median organ cost has more than doubled. We propose potential solutions for consideration at this critical juncture in the field of transplantation. Policymakers should choose equitable and sustainable access for this lifesaving discipline.
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