The basic problem with transplanting adult lungs into children is that the lungs need to be “resized” to fit the child. It adds another level of risk to what is already a fairly risky procedure. That’s one of the reasons that the organization that oversees transplants, the Organ Transplant and Procurement Network (OTPN), had a policy of not approving adult lungs for transplant into children under 12 years old. But Sarah’s parents sued, and so the OTPN decided to keep its “Under 12 rule” but create a special review option for one year to consider exceptions on a case by case basis. So now we have a precedent that may embolden the parents of other needy children to sue for what they want. We should all be happy that young Sarah survived the surgeries and is doing well, but make no mistake; that means that the two sets of lungs didn’t go to someone else.
When it comes to such rare and precious resources as human organs, the decisions regarding who gets them are likely to remain contentious. This is worth talking about; who should decide, and how should they decide? The OPTN’s special review option is set to expire in one year unless the full board of directors votes to keep it. I’ll be interested to see what they do.
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