Lessons learned from the case of Sarah Murnaghan

摘要

Recently, it seems that heart and lung transplantation has been a source of political and media frenzy, exemplified by the case of Sarah Murnaghan and federal court interventions in transplant allocations. Instead of viewing this case as an outlier, it could be used as an opportunity to revisit transplant selection committee practices to ensure transparent and consistent decision making. To that end, practical recommendations are provided below.The parents of 10-year-old Sarah Murnaghan, a patient with end-stage cystic fibrosis, took issue with the United Network of Organ Sharing (UNOS) rule that pediatric patients aged younger than 12 years should be given low priority for lung transplantation from adult donors. The Murnaghans raised two distinct claims: (1) that the UNOS rule reflected age-based discrimination and (2) that the transplant team lacked transparency in that its members did not explain the decision-making process. In an unprecedented judicial maneuver, a United States district federal judge issued a temporary restraining order suspending the UNOS rule.