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U.S. group amends transplant policy for kids after lawsuits

By Julie Steenhuysen

CHICAGO (Reuters) - A U.S. group that sets policy for organ transplants voted on Monday to give some children access to adult organs after the parents of two children successfully sued to add them to the adult list for lung transplants.

The cases, both in Pennsylvania, have touched off a debate in the United States over how donor organs - a scarce, life-saving resource - should be allocated among the 1,659 people, including 30 children, on the waiting list for a lung transplant.

For the adult list, data on patients aged 12 and older is thrown into a complicated computer program that arrives at a score which determines where they sit in line for a donor organ.

Since there was too little data on children under 12 when the program was put in place in 2005, transplant experts devised a different system that takes into account the child's age and severity of illness and assigns a priority code of 1 or 2. Children under 12 have first pick of pediatric lungs, but are generally not eligible for an adult lung.

That two-tiered policy came under fire on June 5 as the mother of 10-year-old Sarah Murnaghan of Pennsylvania, who suffers from end-stage cystic fibrosis, successfully sued to have her daughter added to the list for adult organs.

Murnaghan's case was followed last week by a suit brought by the mother of 11-year-old Javier Acosta of New York, who also has cystic fibrosis, who also won the right to have her son's name added to the adult organ list.

As part of the rulings, the U.S. District Court Judge Michael Baylson ordered U.S. Health Secretary Kathleen Sebelius to request a review of how organs are allocated.

In an emergency session on Monday, members of the Organ Procurement and Transplantation Network's executive committee adopted a new, temporary policy to allow children under 12 to be classified as adolescents, putting them in the running for adult organs.

The decision was based on new data presented to the committee that suggested that some younger patients were receiving fewer offers of organs than adults, and that some older children may be suitable candidates for an adult organ.

The new classification for adolescents will be in place until July 1, 2014, giving the group time to review its policies to ensure that all organs are allocated fairly.

Dr Edward Garrity, associate director of transplantation services at the University of Chicago, who helped devise the 2005 transplant policy, said he was "very concerned about a legal decision driving medical care."

He said the current system was "carefully crafted and scientifically analyzed to be as fair and equitable and understandable as can be."

He said he was concerned about how children would be ranked on the adult transplant list, noting that it was possible a child could jump ahead of a more deserving adult.

In the context of the number of adults waiting for a transplant, the number of children was "not a huge number, but it is if you are denied at transplant because someone else jumped the line," he said.

(Reporting by Julie Steenhuysen; Editing by David Brunnstrom)

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