Policy networks can inform policy design with expertise and build support, or at least acquiescence, for policy change. When policy networks do not arise organically, they can be created through various forms of constructed collaboration. At one extreme, the construction may simply involve tapping expertise through advisory committees. At the other extreme, the constructed arena may delegate policy choice to organizations of stakeholders like the OPTN. Prior research assessed the capacity of the OPTN for evidence-based incremental change in organ allocation rules. This study considered continuous distribution as a radical change in allocation rules. The success of the lung CD serves as a proof of concept for continuous distribution and suggests that it can be effectively implemented for other organs. It also considers stakeholder rulemaking as an institutional alternative in other complex policy areas. Key considerations include whether it can be constructed to engage all relevant stakeholders and induce their willingness to provide expertise.