Abstract
Purpose On November 24, 2017, in an emergency action, the OPTN changed lung allocation policy by removing the donor service area (DSA) as the first unit of allocation for deceased donor lungs and replaced it with a 250 nautical mile (NM) circle around the donor hospital. Methods OPTN data on adult lung candidates and recipients was analyzed pre (11/25/2016- 8/24/2017) and post policy change (11/25/2017- 8/24/2018, 9 months). Comparisons were made to study the differences between cohorts. Results Comparison between the pre era (N=1,806) and the post era (N=1,843) cohorts revealed a significant increase in the match LAS at transplant (mean pre=47.24 vs. post=49.68, p Conclusion As expected, there was an increase in the distance traveled from transplant center to donor hospital to provide organs to candidates with a higher severity of illness. The waiting list mortality for LAS 60-70 decreased while transplant rate only decreased significantly for LAS 40-50. Lung utilization has not changed but an increase in the use of EVLP is noted. Continued evaluation is needed to understand the full effects of this policy change.
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