Last year, 10-year-old Sarah Murnaghan was dying and in need of a lung transplant. However, the transplant of donor adult lungs into children under 12 was something that the Organ Procurement and Transplantation Network (OPTN) was not considering. A special provision was made that saved young Sarah’s life, and the OPTN launched a year-long study to determine whether more children under 12 should be eligible for adult lung transplants.

On Monday, the OPTN announced that changes were made as a result of the study, and now “a very limited group of young lung transplant candidates” will receive “additional priority for matching offers.”

According to a statement issued by the transplant network, a more individual needs-based approach was considered in the context of the benefits transplantation can provide. In other words, strict guidelines may sometimes exclude those that may benefit from a transplant.

“Nobody wants children, or anybody, to die on the waiting list,” said Dr. George Mallory, medical director of the lung transplant program at Texas Children’s Hospital in Houston, earlier this year as the year-long study was coming to a close.

“This is a difficult balance for very young lung transplant candidates in particular,” said Stuart Sweet, board secretary for the transplant network and its parent organization, the United Network for Organ Sharing. “There are very few candidates in this age group and the progression of their lung disease may be considerably different from other patients, even those just a few years older. This exception is meant to provide an appropriate balance for a specific group of candidates.”

At the time Sarah Murnaghan sought donor lungs, the policy guiding allocations considered candidates under 18 as either adolescents (12 to 18 years of age) and pediatrics (under 12 years of age), and priority was given to adolescents, meaning that they could receive lungs from either adolescent or adult donors. Pediatric candidates could only receive pediatric-donor lungs.

The most recent lung transplant guidelines are available online.