The new algorithm was supposed to help distribute lungs more fairly to people who desperately needed life-saving transplants.

But a flaw in the process for awarding the organs to sick and dying patients meant some people didn’t receive the care they were entitled to, the Chicago Tribune has learned.

Specifically, patients with type O blood received fewer transplants last year than would have been otherwise expected, according to records obtained by the Tribune and interviews with patients, surgeons and advocates. That’s because the new system failed to fully account for the fact that type O patients can accept donor lungs only from people who also have type O blood.

The problem occurred over a six-month period in 2023 but is only now coming to light publicly amid a dispute over how many patients were affected and whether the organization governing transplants should have been more transparent in explaining what went wrong.

A group of transplant surgeons has criticized the Organ Procurement and Transplant Network, which sets rules for organ distribution under a contract with the federal government, for not releasing more information publicly about an incident the surgeons described in a letter as “deeply troubling.”

When the network changed its algorithm for lung distribution in March 2023, it touted the new system as more efficient and fair, helping ensure vital organs didn’t go to waste. A key change was scrapping firm geographical boundaries on how far organs can travel for transplant, recognizing that those limits kept some patients waiting too long for organs to become available in their area. It also added a score that weighted and combined a number of factors related to the patient’s need for a transplant and how well the person matched the organ donor.

In July, the network acknowledged an error with the revised algorithm, publishing a report that said roughly 35 fewer transplants had been given to type O patients than would have been expected in the first three months of the program’s implementation. A change to correct the issue did not go into effect until the end of September, but a six-month report from the network, issued the following month, did not increase the estimate of the impact from 35.

In a paper presented this month to the American Transplant Congress, a University of Colorado team argued for a higher number, calculating that the error likely resulted in 138 fewer lung transplants for type O patients. The O blood type is the most common, amounting to nearly half the U.S. population.

“This just shouldn’t happen,” Jesse Schold, a professor of surgery at Colorado and the paper’s coauthor, said in an interview with the Tribune.

In the presentation, Schold and the professors said they are concerned that even the repaired system might “still result in disparities in transplant rates by blood type.”

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