Effects of Lung Allocation Score on Waiting List Rankings and Transplant Procedures

Lingaraju, R.; Blumenthal, Nancy P.; Kotloff, Robert M.; Christie, Jason D.; Ahya, Vivek N.; Sager, J.S.; Pochettino, Alberto; Hadjiliadis, Denis

doi:10.1016/j.healun.2006.05.007

Cited by 48 publications

(35 citation statements)

References 8 publications

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“…Previous studies demonstrated that implementation of the LAS system decreased waiting list mortality and waiting time, with no significant effect on survival. [7][8][9][10] However, during the LAS era, higher rates of primary graft dysfunction and increased intensive care unit stays have also been observed. 7 The objective of this study is to determine if posttransplant outcomes, including morbidity and mortality, are associated with LAS at the time of transplantation.…”

Section: Resultsmentioning

confidence: 99%

High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation

Russo

Iribarne

Hong

et al. 2010

Chest

124

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Section: Resultsmentioning

confidence: 99%

High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation

Russo

Iribarne

Hong

et al. 2010

Chest

124

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“…By removing waiting time from the equation, the LAS has drastically reduced the number of patients on the waiting list, effectively shortening time to transplantation for all diagnoses (17). Earlier studies that have attempted to evaluate the impact of the LAS are limited in size, but they suggest that under the new system transplant priority has increased for patients with IPF and decreased for patients with COPD (8,10). Our results support these findings in that we observed a significant increase in transplantation for IPF, relative to other diagnoses, accompanied by a significant decrease in death on the waiting list.…”

Section: Discussionmentioning

confidence: 99%

“…Studies of the effect of the LAS have focused predominantly on patients with IPF, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) (8)(9)(10)(11). Because IPAH accounts for only a minority of the total lung transplants performed each year, studies published to date…”

mentioning

confidence: 99%

Impact of the Lung Allocation Score on Lung Transplantation for Pulmonary Arterial Hypertension

Chen¹,

Shiboski²,

Golden³

et al. 2009

Am J Respir Crit Care Med

151

107

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Rationale: In 2005, lung allocation for transplantation in the United States changed from a system based on waiting time to a system based on the Lung Allocation Score (LAS). Objectives: To study the effect of the LAS on lung transplantation for idiopathic pulmonary arterial hypertension (IPAH) compared with other major diagnoses. Methods: We studied 7,952 adults listed for lung transplantation between 2002 and 2008. Analyses were restricted to patients with IPAH, idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). Transplantation, waiting list mortality, and post-transplant mortality were compared between diagnoses for patients listed before and after implementation of the LAS. Measurements and Main Results: The likelihood of transplantation from the waiting list increased for all diagnoses after implementation of the LAS. Waiting list mortality decreased for every diagnosis, except for IPAH, which remained unchanged. Implementation of the LAS was not associated with changes in post-transplant mortality for any diagnosis. Under the LAS system, patients with IPAH were less likely to be transplanted than patients with IPF (hazard ratio [HR], 0.53; P , 0.001) or CF (HR, 0.49; P , 0.001) and at greater risk of death on the waiting list than patients with COPD (HR, 3.09; P , 0.001) or CF (HR, 1.83; P 5 0.025) after adjustment for demographics and transplant type. Post-transplant mortality for IPAH was not statistically different from that of other diagnoses. Conclusions: Implementation of the LAS has improved the likelihood of lung transplantation for listed patients with IPAH, but mortality on the waiting list remains high compared with other major diagnoses.

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“…As forced vital capacity is particularly low in restrictive lung diseases such as idiopathic pulmonary fibrosis, these patients have shorter time on the transplantation wait list, resulting in longer wait list times for patients with COPD (73). LVRS, a procedure that generally offers less functional benefit but is significantly less morbid, can play a role in these individuals with the goal of offering some functional benefit, which could obviate the need for transplantation.…”

Section: Discussionmentioning

confidence: 99%

Lung Transplantation and Lung Volume Reduction Surgery versus Transplantation in Chronic Obstructive Pulmonary Disease

Patel¹,

DeCamp²,

Criner³

2008

Proceedings of the American Thoracic Society

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Lung transplantation and lung volume reduction surgery are surgical options for patients with advanced chronic obstructive pulmonary disease that is refractory to medical treatment. In this review, we discuss the differential indications for each procedure, as well as compare their risks and benefits. We also present an algorithm for selecting the most appropriate procedure for individual patients. Finally, we discuss the feasibility and role of lung transplantation after lung volume reduction surgery in the management of selected patients with chronic obstructive pulmonary disease.

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Effects of Lung Allocation Score on Waiting List Rankings and Transplant Procedures

Cited by 48 publications

References 8 publications

High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation

High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation

Impact of the Lung Allocation Score on Lung Transplantation for Pulmonary Arterial Hypertension

Lung Transplantation and Lung Volume Reduction Surgery versus Transplantation in Chronic Obstructive Pulmonary Disease

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