Ninety-day mortality and major complications are not affected by use of lung allocation score.
BACKGROUND
In May 2005 the Organ Procurement Transplant Network (OPTN) and United Network for Organ Sharing (UNOS) implemented the donor lung allocation score (LAS) system to prioritize organ allocation among prospective transplant recipients. The purpose of our study was to determine the impact of LAS implementation on 90-day survival, early complications and incidence of severe primary graft dysfunction (PGD) after the transplant procedure.


METHODS
Early outcomes among 78 patients receiving transplants after the initiation of the scoring system were compared with those of the 78 previous patients. Survival rates at 90 days and 1 year were the primary end-points of the study. Arterial blood-gas measurements were collected for all patients at the time of ICU arrival and at 12, 24 and 48 hours after surgery to determine the distribution of International Society of Heart and Lung Transplant (ISHLT) PGD grade. Major complications within 30 days post-transplant were recorded.


RESULTS
We found a small but significant 1-year survival advantage among post-LAS implementation patients, which was largely due to decreased early mortality in comparison to the control cohort. The incidence of ISHLT Grade 3 PGD measured within the first 24 hours after transplant did not differ between groups, nor was there an increase in the rate of major post-operative complications.


CONCLUSIONS
Implementation of the LAS system has not been associated with an increase in early mortality, immediate PGD or major complications.
McCue
Jonathan D
JD
Department of Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Mooney
Josh
J
Quail
Jacob
J
Arrington
Amanda
A
Herrington
Cynthia
C
Dahlberg
Peter S
PS
D000328:Adult; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D011336:Probability; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D009927:Tissue and Organ Procurement