On March 9, 2023, a new lung allocation policy based on continuous distribution was implemented. Member education and resources are available in the implementation toolkit to help you understand the new policy.
Policy toolkits
Allocation calculators
Lung Composite Allocation Score (CAS) calculator
A guide to calculating the lung composite allocation score (Lung CAS) (PDF - 947 KB) (last updated 11/15/23)
Monitoring reports
- Two-Year Monitoring Report: Amend Adult Heart Status Extension Requirements Two-Year Monitoring Report (PDF - 1 MB) (6/2025)
- Five-Year Monitoring Report: Heart Allocation Proposal to Modify the Heart Allocation System (PDF - 4 MB) (4/2024)
- One-Year Monitoring Report: Amend Adult Heart Status Extension Requirements (PDF - 2 MB) (3/2024)
- Two-Year Monitoring Report: Pediatric National Heart Review Board (PDF - 3 MB) (12/2023)
- One-Year Monitoring Report: Heart Policy to Address Patient Safety Following Device Recall (PDF - 2 MB) (12/2023)
- Four-year heart monitoring report: Proposal to modify the adult heart allocation system (3/2023)
- One-year heart monitoring report: Pediatric National Heart Review Board (12/2022)
- Six-month heart monitoring report: Heart policy to address patient safety following device recall(04/2023)
- Three-month heart monitoring report: Heart policy to address patient safety following device recall (11/2022)
- Three-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF - 7 MB) (9/2022)
- Two-year heart monitoring report: Eliminate the use of DSAs in thoracic allocation (8/2022)
- One-year heart monitoring report: Eliminate the use of DSAs in thoracic allocation (PDF - 4 MB) (7/2020)
- Two-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF - 7 MB) (3/2021)
- One-year heart monitoring report: Proposal to modify the adult heart allocation system (PDF - 4 MB) (3/2020)
- Two-year monitoring report: Lung continuous distribution (PDF - 5 MB) (5/2025)
- 18-month monitoring report: Lung continuous distribution (PDF - 3 MB) (12/2024)
- One-year monitoring report: Lung continuous distribution (PDF - 1 MB) (5/2024)
- Three-month monitoring report: Lung CD-Blood type rating scale modification (PDF - 479 KB) (2/2024)
- Six-month monitoring report: Lung continuous distribution (PDF - 1 MB) (10/2023)
- Three-month monitoring report: Lung continuous distribution(7/2023)
- Nine-month monitoring report available for lower respiratory testing of lung donors (8/2021)
- Two-year monitoring report on removal of DSA from lung allocation (PDF - 2 MB) (2/2020)
Policy & guidance
Heart
- FDA MDR Reporting Requirements (04/2024)
- FDA Regulation of Allograft Heart Valves OPTN Operations and Safety Committee Meeting (4/2024)
- OPTN policy 6: allocation of hearts and heart-lungs (PDF - 3 MB)(2/2022)
- Evaluation plan guidance for policy 6 (PDF - 808 KB) (7/2021)
- Adult heart allocation toolkit
- National Heart Review Board (NHRB) for Pediatrics FAQ (PDF - 922 KB) (7/2021)
- Guidance for Adult Heart Exception Requests (Status 2 Cardiogenic Shock Candidates) (PDF - 448 KB) (2/2021)
- Guidance for Pediatric Heart Exception Requests (PDF - 188 KB) (6/2025)
- Heart Allocation Variances (PDF - 377 KB) (None active as of 3/1/2020)
- Review board guidance for HCM/RCM exception requests (PDF - 775 KB) (10/2018) Effective 10/18/2018
- Review board guidance for adult CHD exception requests (PDF - 192 KB) (12/2017)
Lung
- Guidance for Conducting the Six-Minute Walk Test for Lung Allocation (PDF - 380 KB) (09/2024)
- FDA MDR Reporting Requirements (04/2024)
- OPTN policy 10: allocation of lungs (PDF - 3 MB) 2/2022)
- Evaluation plan guidance for policy 10 (PDF - 808 KB) (7/2021)
Date Last Reviewed: