Increasing Lung Allocation Scores Predict Worsened Survival Among Lung Transplant Recipients

Overview

Journal Am J Transplant

Publisher Elsevier

Specialty General Surgery

Date 2010 Feb 4

PMID 20121747

Citations 24

Authors

V Liu

M R Zamora

G S Dhillon

D Weill

Affiliations

Soon will be listed here.

Abstract

Implemented in 2005, the lung allocation score (LAS) aims to distribute donor organs based on overall survival benefits for all potential recipients, rather than on waiting list time accrued. While prior work has shown that patients with scores greater than 46 are at increased risk of death, it is not known whether that risk is equivalent among such patients when stratified by LAS score and diagnosis. We retrospectively evaluated 5331 adult lung transplant recipients from May 2005 to February 2009 to determine the association of LAS (groups based on scores of < or =46, 47-59, 60-79 and > or =80) and posttransplant survival. When compared with patients with LAS < or = 46, only those with LAS > or = 60 had an increased risk of death (LAS 60-79: hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.21-1.90; LAS > or = 80: HR, 2.03; CI, 1.61-2.55; p < 0.001) despite shorter median waiting list times. This risk persisted after adjusting for age, diagnosis, transplant center volume and donor characteristics. By specific diagnosis, an increased hazard was observed in patients with COPD with LAS > or = 80, as well as those with IPF with LAS > or = 60.

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References

Axelrod D, Guidinger M, McCullough K, Leichtman A, Punch J, Merion R . Association of center volume with outcome after liver and kidney transplantation. Am J Transplant. 2004; 4(6):920-7. DOI: 10.1111/j.1600-6143.2004.00462.x. View

Merlo C, Weiss E, Orens J, Borja M, Diener-West M, Conte J . Impact of U.S. Lung Allocation Score on survival after lung transplantation. J Heart Lung Transplant. 2009; 28(8):769-75. DOI: 10.1016/j.healun.2009.04.024. View

Kozower B, Meyers B, Smith M, De Oliveira N, Cassivi S, Guthrie T . The impact of the lung allocation score on short-term transplantation outcomes: a multicenter study. J Thorac Cardiovasc Surg. 2008; 135(1):166-71. DOI: 10.1016/j.jtcvs.2007.08.044. View

Chen H, Shiboski S, Golden J, Gould M, Hays S, Hoopes C . Impact of the lung allocation score on lung transplantation for pulmonary arterial hypertension. Am J Respir Crit Care Med. 2009; 180(5):468-74. PMC: 2742763. DOI: 10.1164/rccm.200810-1603OC. View

Christie J, Edwards L, Aurora P, Dobbels F, Kirk R, Rahmel A . Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult lung and heart/lung transplantation report--2008. J Heart Lung Transplant. 2008; 27(9):957-69. DOI: 10.1016/j.healun.2008.07.018. View

McCue J, Mooney J, Quail J, Arrington A, Herrington C, Dahlberg P . Ninety-day mortality and major complications are not affected by use of lung allocation score. J Heart Lung Transplant. 2008; 27(2):192-6. DOI: 10.1016/j.healun.2007.11.001. View

Iribarne A, Russo M, Davies R, Hong K, Gelijns A, Bacchetta M . Despite decreased wait-list times for lung transplantation, lung allocation scores continue to increase. Chest. 2008; 135(4):923-928. DOI: 10.1378/chest.08-2052. View

Egan T, Murray S, Bustami R, Shearon T, McCullough K, Edwards L . Development of the new lung allocation system in the United States. Am J Transplant. 2006; 6(5 Pt 2):1212-27. DOI: 10.1111/j.1600-6143.2006.01276.x. View

Lingaraju R, Blumenthal N, Kotloff R, Christie J, Ahya V, Sager J . Effects of lung allocation score on waiting list rankings and transplant procedures. J Heart Lung Transplant. 2006; 25(9):1167-70. DOI: 10.1016/j.healun.2006.05.007. View

10.

Venuta F, Rendina E, De Giacomo T, Andreetti C, Coloni G . Mortality on the lung transplantation waiting list. J Heart Lung Transplant. 2003; 22(7):828; author reply 828-9. DOI: 10.1016/s1053-2498(02)00634-4. View

11.

Pierson 3rd R, Barr M, McCullough K, Egan T, Garrity E, Jessup M . Thoracic organ transplantation. Am J Transplant. 2004; 4 Suppl 9:93-105. DOI: 10.1111/j.1600-6135.2004.00401.x. View

12.

Gries C, Mulligan M, Edelman J, Raghu G, Curtis J, Goss C . Lung allocation score for lung transplantation: impact on disease severity and survival. Chest. 2007; 132(6):1954-61. DOI: 10.1378/chest.07-1160. View

13.

Hosenpud J, Breen T, Edwards E, Daily O, Hunsicker L . The effect of transplant center volume on cardiac transplant outcome. A report of the United Network for Organ Sharing Scientific Registry. JAMA. 1994; 271(23):1844-9. View