Murnaghans Face Backlash After Sarah's Lung Transplant


Here's how the Under 12 Rule -- which is more like a series of rules -- actually works.

Lung transplant candidates older than 12 are assigned a lung allocation score, or LAS, based on a complex mathematical formula that includes the patient's age and size. For transplant patients younger than 12 -- of which there are 20 nationally compared with about 1,600 adults -- the LAS is not used. Instead, patients are broken into "priority 1" and "priority 2." It's this difference that has been called discriminatory in court.

"If you are under 12 it is the amount of time you have waited that matters," Murnaghan wrote in her clarification post. "So if you are dying and have been on the list one hour you will NOT get the lungs."

This is not 100 percent true. Although time on the list is considered, an OPTN spokeswoman told that it's not the only thing that matters. Instead, lungs are allocated to the 20 children under 12 on the list by medical urgency, blood type and time on the list.

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.

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