'Under 12 Rule' Review Begins for Child Lung Transplants


Children get priority for lungs donated from children younger than 12, but they have to wait for children between 12 and 17 to decline lungs donated from 12- to 17-year-olds before they get a chance at them. Lungs donated by anyone older than 18 are offered to all candidates older than 12, depending on their LAS. Only if all local matching candidates 12 and older decline the adult lungs can they be offered to children within 500 miles of the hospital where the lungs were harvested.

Moon said she supports the decision to take another look at the Under 12 Rule, but that an adult lung transplant would likely do Sarah and Javier more harm than good.

Dr. David Cronin, a transplant surgeon at the Medical College of Wisconsin in Milwaukee, said most adult donor organs are not suitable for child recipients. Resized lung transplants -- called lobe transplants -- are not commonly performed on children.

"Is this prolonging [Sarah's] suffering in a way that's dangerous?" Moon asked.

Cronin said he "totally" disagreed with Baylson's ruling.

"The allocation system is transparent, equitable, fair and represents evidence-based medicine," Cronin said. "We have come a long way in fine-tuning the system and improving access and equity."

Moon said the children's parents can't be faulted for fighting the organ allocation system, because it's their job to put their children first. Even though Moon is a pediatrician, she said she takes her children to another doctor when they're sick because she can't be objective about their medical care.

"How is that helping?" she asked of granting a potentially harmful lung transplant to a child. "Is that medicine or is that just acquiescing to a parent's anxiety? It's a harsh thing to say, but parents don't get to drive medical choices for that reason."

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