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The Alpha-1 Association remains concerned about the changes to the organ allocation system and continues to monitor the data released to ensure that the new system does not disadvantage individuals with Alpha- 1.
The Alpha-1 Association agreed entirely with the mandate that the allocation of organs to lung transplant recipients be made as equitable as possible, based on science and fairness. We wish to thank the Organ Procurement and Transplant Network for their diligent efforts to improve upon the past system. We agree that the old system of "time-on-list" allocation was not adequate and failed to take severity of disease or expected mortality into account.
In our opinion, the ideal organ allocation system would identify those in most immediate need of transplantation and move them to the top of the "waiting list" while trying to avoid transplantation for individuals in whom such a procedure is likely to be futile. This type of analysis has guided the recently developed and relatively successful changes in organ allocation procedures for heart and liver transplants.
Problems have prevented a simple transfer of these principals to lung transplantation. Most notable is our inability to accurately predict risk of mortality in a given individual with severe lung disease. Successful lung transplantation is a relatively new endeavor, compared with heart and liver transplantation, and as such our database of outcomes is somewhat restricted. Finally, the technology of lung transplantation has improved at an accelerating rate and yesterday's statistics may not apply to today's transplants.
The Association remains vigilant in obtaining the public data and determining if individuals with Alpha-1 are being treated fairly within the new allocation structure.
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