• Posted May 21, 2025

Deaths Waiting For Lung Donation Have Dropped Under New Guidelines

New guidelines for allocating donated lungs are saving more lives, a new study says.

By prioritizing medical urgency, the guidelines caused a dramatic decline in the number of people who die waiting for a lung transplant, researchers reported Sunday at the American Thoracic Society’s international conference in San Francisco.

Patients are now three times less likely to die on the waitlist than before 2017, when a lawsuit kicked off a rethinking of the way donated lungs were allocated, researchers say.

The sickest patients on the waitlist saw the greatest benefit, researchers added.

“We always want to make sure that any time we make a change to the allocation system that we’re improving outcomes, especially for our sickest patients,” lead researcher Dr. Mary Raddawi, a second-year pulmonary and critical care fellow at Columbia University Irving Medical Center, said in a news release. “This provides confirmation that we’re on the right track.”

Prior to 2017, donor lungs were handed out based on geographical proximity, meaning that people living near the donor received priority access. The lawsuit caused the allocation radius to be expanded to a wider area, so the organs were available to more people.

Then in 2023, the United Network for Organ Sharing implemented a new Composite Allocation Score that prioritized a person’s medical urgency along with other health factors in choosing who gets donor lungs.

About 11% of patients died or were delisted while waiting for a transplant prior to 2017, but that declined to about 8% after proximity was expanded and dropped to 4% after the new guidelines were implemented, results show.

“When you think about the fact that now we’re focusing on many different factors, including medical urgency, it makes sense that the waitlist mortality would go down for our sicker patients — but it is nice to see the actual numbers,” Raddawi said.

The results show how important it is for doctors to advocate for their sickest patients, to make sure their medical urgency is reflected in their score, Raddawi said.

“We’re seeing that it really does make a difference for them,” she said.

The team next plans to look at the outcomes in greater detail, to see if certain factors considered in the donation scoring are linked to better outcomes than others.

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The Health Resources & Services Administration has more on organ donation.

SOURCE: American Thoracic Society, news release, May 18, 2025