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. 2022 Dec;22(12):2971-2980.
doi: 10.1111/ajt.17160. Epub 2022 Aug 9.

Expected effect of the lung Composite Allocation Score system on US lung transplantation

Maryam Valapour  1   2 , Carli J Lehr  1 , Andrew Wey  2 , Melissa A Skeans  2 , Jonathan Miller  2 , Erika D Lease  3
Affiliations
Free article

Expected effect of the lung Composite Allocation Score system on US lung transplantation

Maryam Valapour et al. Am J Transplant. 2022 Dec.
Free article

Erratum in

Abstract

Efforts are underway to transition the current lung allocation system to a continuous distribution framework whereby multiple factors are simultaneously combined into a Composite Allocation Score (CAS) to prioritize candidates for lung transplant. The purpose of this study was to compare discrete CAS scenarios with the current concentric circle-based allocation system to assess their potential effects on the US lung transplantation system using the Scientific Registry of Transplant Recipients' thoracic simulated allocation model. Six alternative CAS scenarios were compared over 10 simulation runs using data from individuals on the lung transplant waiting list from January 1, 2018, through December 31, 2019. Outcome measures were transplant rate, count, waitlist deaths, posttransplant deaths within 2 years, donor-to-recipient distance, and percentage of organs predicted to have flown. Across scenarios, waitlist deaths decreased by 36% to 47%, with larger decreases in deaths at lower placement efficiency weight and higher weighting of the waitlist outcomes. When waitlist outcomes were equally weighted to posttransplant outcomes, more transplants occurred in individuals with the highest expected posttransplant survival. All CAS scenarios led to improved overall measures of equity compared with the current Lung Allocation Score system, including reduced waitlist deaths, and resulted in similar posttransplant survival.

Keywords: continuous distribution; geography; lung transplant; organ allocation; outcomes.

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References

REFERENCES

    1. Egan TM, Murray S, Bustami RT, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006;6(5 Pt 2):1212-1227.
    1. Mooney JJ, Bhattacharya J, Dhillon GS. Effect of broader geographic sharing of donor lungs on lung transplant waitlist outcomes. J Heart Lung Transplant. 2019;38(2):136-144.
    1. OPTN Lung Transplantation Committee. Continuous distribution of lungs concept paper. https://optn.transplant.hrsa.gov/policies-bylaws/public-comment/continuo.... Accessed March 30, 2022.
    1. Snyder JJ, Salkowski N, Wey A, Pyke J, Israni AK, Kasiske BL. Organ distribution without geographic boundaries: a possible framework for organ allocation. Am J Transplant. 2018;18(11):2635-2640.
    1. OPTN Lung Transplantation Committee. Establish continuous distribution of lungs. https://optn.transplant.hrsa.gov/media/esjb4ztn/20211206-bp-lung-establi.... Accessed March 30, 2022.