Results of Broader Sharing of Young Pediatric Donor Lungs and Priority Allocation System for Young Pediatric Lung Candidates

W. Cherikh,¹ A. Wilk,¹ L. Edwards,¹ G. Visner,² Y. Cheng,¹ S. Sweet.³

¹United Network for Organ Sharing, Richmond, VA
²Boston Children's Hospital, Boston, MA
³Washington Univ, St. Louis, MO.

Meeting: 2015 American Transplant Congress

Abstract number: 122

Keywords: Allocation, Lung, Pediatric, Waiting lists

Session Information

Session Name: Concurrent Session: Lung: Optimizing Outcomes

Session Type: Concurrent Session

Date: Sunday, May 3, 2015

Session Time: 4:00pm-5:30pm

Presentation Time: 4:48pm-5:00pm

Location: Room 115-C

Background. Two major changes for allocation of young pediatric (ped) lung (LU) donors and young ped candidates were implemented on 9/12/10. LUs from 0-11 year old (yo) donors are shared more broadly by combining local, Zone A, and Zone B for 0-11 yo ped candidates. A simple 2-tiered priority system for 0-11 yo LU candidates was also implemented to direct donor LUs to the sickest (Priority 1) candidates first. The current policy evaluation was conducted for the OPTN Pediatric Committee.

Data and Methods. OPTN data was analyzed for LU additions 43 mos post-policy (PostPol) implementation (9/12/10-4/11/14). Relative risk (RR) of death or transplant (tx) was calculated for candidates on the list 43 mos PostPol period stratified by age. Deceased donor (DD) LU alone tx during 43 mos PostPol were tabulated by donor age and geographic location. One-yr Kaplan-Meier patient survival was calculated for tx during 9/12/10-4/11/13.

Results. There were 105 0-11 yo additions PostPol, of which 59 (56%) were 6-11 yo at listing and 49 (47%) were listed as Priority 1 (P1). Figure 1 shows peds of any age group did not have a significantly increased risk of death compared to adults. Peds aged 0-5 and 12-17 had a significantly higher risk of tx than adults, while peds aged 6-11 had a similar risk of tx compared to adults.

All 0-5 yo recips received 0-5 yo donor LUs and almost 60% of 6-11 yo recips received 6-11 yo donor LUs. Among 63 DD LU tx in 0-11 yo recips, 78% were P1. Of the P1 tx, 94% were performed in combined local, Zone A, and Zone B. There was no difference in 1-yr patient survival among different recip age groups (p=0.23).

Conclusions. Results of the broader sharing policy show similar death rates in ped and adult age groups, and similar tx rates for 6-11 yo peds and adults. Most 0-11 yo recips received tx from donors in the same age group. One-yr patient survival was comparable among different recip age groups. The Pediatric Committee will continue to monitor this policy as more data are available.

To cite this abstract in AMA style:

Cherikh W, Wilk A, Edwards L, Visner G, Cheng Y, Sweet S. Results of Broader Sharing of Young Pediatric Donor Lungs and Priority Allocation System for Young Pediatric Lung Candidates [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/results-of-broader-sharing-of-young-pediatric-donor-lungs-and-priority-allocation-system-for-young-pediatric-lung-candidates/. Accessed November 21, 2024.

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