Was Sarah Murnaghan Treated Justly?

Author:

deSante Jennifer1,Caplan Arthur2,Hippen Benjamin3,Testa Giulano4,D. Lantos John5

Affiliation:

1. Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;

2. Division of Medical Ethics, NYU Langone Medical Center, New York, New York;

3. Carolinas Medical Center, Charlotte, North Carolina;

4. Living Donor Liver Transplantation, Baylor University Medical Center, Dallas, Texas; and

5. eChildren's Mercy Hospital, Kansas City, Missouri

Abstract

Lung transplantation is a potentially life-saving procedure for patients with irreversible lung failure. Five-year survival rates after lung transplantation are >50% for children and young adults. But there are not enough lungs to save everyone who could benefit. In 2005, the United Network for Organ Sharing developed a scoring system to prioritize patients for transplantation. That system considered transplant urgency as well as time on the waiting list and the likelihood that the patient would benefit from the transplant. At the time, there were so few pediatric lung transplants that the data that were used to develop the Lung Allocation Score were inadequate to analyze and prioritize children, so they were left out of the Lung Allocation Score system. In 2013, the family of a 10-year-old challenged this system, claiming that it was unjust to children. In the article, we asked experts in health policy, bioethics, and transplantation to discuss the issues in the Murnaghan case.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference28 articles.

1. Levs J, Welch C, Asher Z, Bixler J. Dying girl's plight sparks fight over organ transplants. CNN Cable News Network. May 29, 2013. Available at: http://edition.cnn.com/2013/05/29/health/pennsylvania-girl-lungs. Accessed December 11, 2013

2. OPTN: Organ Procurement and Transplantation Network. Available at: http://optn.transplant.hrsa.gov/policiesAndBylaws/nota.asp. Accessed December 11, 2013

3. Organ Procurement and Transplantation Network (OPTN) Policies. Policy 10: Allocation of Lungs. Available at: http://optn.transplant.hrsa.gov/ContentDocuments/OPTN_Policies_PC_08-2013.pdf#nameddest=Policy10. Accessed December 11, 2013

4. Long-term outcomes of cadaveric lobar lung transplantation: helping to maximize resources.;Keating;J Heart Lung Transplant,2010

5. Size-reduced lung transplantation in children—an option worth to consider!;Benden;Pediatr Transplant,2010

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