The findings, which are published in the American Journal of Transplantation, help inform ongoing discussions regarding potential changes to the nation's lung allocation policy.
According to the lung allocation policy in place in the United States since 2005, lungs from adolescent donors (aged 12 to 17 years) are preferentially offered to adolescent candidates; if there are no suitable adolescent candidates in the local donation service area, the organ is offered to a local candidate aged 0 to 11 years.
Earlier this year, though, a US Federal Court directed the Secretary of Health and Human Services to allow a 10-year-old patient to be considered alongside older candidates for lungs from adolescent and adult donors without consideration of her age. The plaintiff's filing included data indicating that death rates for patients on the waiting list were higher for children younger than 12 years of age than for adolescents and adults.
Bertram Kasiske, MD, of the Scientific Registry of Transplant Recipients (SRTR) in Minneapolis, led a team that examined the validity of those data. "In our capacity as researchers who support the policy process, we addressed whether or not children in the 6 to 11 age range, whose size might afford them benefit from access to lungs from donors aged 12 and older, were greatly disadvantaged by the current policy," said Dr. Kasiske. The researchers analyzed information from the Scientific Registry of Transplant Recipients, which includes data on all donors, wait-listed candidates, and transplant recipients in the United States. The investigators looked specifically at mortality rates by age for candidates registered on the lung transplant waiting list between January 1, 1999, and December 31, 2011.
The team found that children aged 6 to 11 years who are on the waiting list die at a rate that is similar to older candidates. For children aged 0 to 5 years, death rates are higher compared with older children and adults, but transplant rates are not lower compared with other age groups. The researchers also discovered that children aged 6 to 11 years were transplanted at lower rates in the years immediately following implementation of the 2005 lung allocation policy; however, this difference seems to have disappeared in recent years.
"The Thoracic Transplantation Committee of the Organ Procurement and Transplantation Network (OPTN) will be re-evaluating lung allocation policy as it applies to children during late 2013 and early 2014. This research will help inform the debate about pediatric lung allocation policy," said Dr. Kasiske.
In an accompanying editorial, Stuart Sweet, MD, PhD, of Washington University in St. Louis, and Mark Barr, MD, of the University of Southern California in Los Angeles, noted that there are several other factors that should be considered as officials and the transplant community consider whether changes to pediatric lung allocation are warranted. "Opportunities for improvement include bringing the lung donor yield in the 0-11 age group closer to the yield in adolescents, relaxing geographic allocation boundaries to ensure that pediatric lungs are offered first to children, and reserving deceased donor lobar transplant for circumstances where suitably sized donor organs are not available," they wrote.
The SRTR's work was conducted under the auspices of the Minneapolis Medical Research Foundation, contractor for the SRTR. The views expressed therein are those of the authors and not necessarily those of the US Government, UNOS, or the OPTN.
Ben Norman | EurekAlert!
Do microplastics harbour additional risks by colonization with harmful bacteria?
05.04.2018 | Leibniz-Institut für Ostseeforschung Warnemünde
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.
Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...
Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.
Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.
The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
24.04.2018 | Information Technology
24.04.2018 | Earth Sciences
24.04.2018 | Life Sciences