Proposal for Adolescent Classification Exception for Pediatric Lung Candidates

1. Proposal for Adolescent Classification Exception for Pediatric Lung Candidates Thoracic Organ Transplantation Committee Spring 2014

2. The Problem • Some young pediatric lung candidates are large enough to accept lungs from donors 12 and older, but do not have priority • Adolescent classification exception gives pediatric lung candidates access to larger sized donors • Adolescent classification exception policy expires July 1, 2014

3. Goal of the Proposal • Reduce waiting list mortality rates for pediatric lung candidates • Gain a better understanding of the relationship between the LAS and pediatric candidates

4. How the Proposal will Achieve its Goal • Centers can continue to apply for adolescent classification exceptions for young pediatric lung candidates • Must report all LAS data for candidates less than 12 with approved adolescent classification exceptions

5. Supporting Evidence • 10 candidates with approved adolescent classification exception since June 2013 • 5 transplanted, 4 still waiting, 1 died • Age at time of exception request • 7 were 10-11 years old, 3 were 6-9 years old • Blood type • 6 O, 2 A, 2 B • Diagnoses • 6 CF, 2 primary arterial hypertension, 1 ARDS/pneumonia, 1 pulmonary veno-occlusive disease • LAS score exception request • 4 requests for LAS score exception

6. What Members Will Need to Do • Centers can apply for adolescent classification exceptions for young pediatric candidates • Must maintain pediatric and adolescent records for candidates with approved adolescent classification exceptions* • Must report all LAS variables for candidates with an adolescent classification exception *No additional registration fee

7. Questions? • Steven Webber, M.D., MBChB, MRCP Committee Chair steven.a.webber@vanderbilt.edu • Name Region # Representativename@email • Liz Robbins Callahan Committee Liaison liz.robbins@unos.org