Scott D. Halpern, MD, PhD
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1487.
Halpern SD. The 2013 Lung Allocation Controversy. Ann Intern Med. 2013;159:794-795. doi: 10.7326/0003-4819-159-11-201312030-00022
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Published: Ann Intern Med. 2013;159(11):794-795.
Mr. Harvey raises issue with my characterization of the judicial review process in the cases of Murnaghan and Acosta because of a specific rule commonly referred to as the OPTN “Final Rule” (or 42 CFR 121) (1) dictating that medical urgency be a basis for organ allocation. The relevant sections of this rule state that “transplant candidates shall be grouped by status categories ordered from most to least medically urgent” and that “criteria for status designations shall contain explicit thresholds for differentiating among patients and shall be expressed, to the extent possible, through objective and measurable medical criteria.” Current lung allocation policies in adults and children meet these criteria. Existing policies categorize children as Priority 1 or Priority 2 on the basis of explicit criteria reflecting medical urgency.
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