title: Lung allocation score and health-related quality of life in Japanese candidates for lung transplantation.
abstract: OBJECTIVE
  The lung allocation score (LAS) system has been implemented to reduce waiting list time and mortality in the USA, but it remains uncertain how the LAS would reflect the impairment in health-related quality of life (HRQOL), which is another lung transplantation treatment goal to be improved in addition to survival. We thus investigated the relationships of the LAS with mortality and HRQOL in Japanese lung transplantation candidates.
  
  
  METHODS
  One hundred and two candidates for lung transplantation at Kyoto University Hospital between 2009 and 2013 were consecutively recruited to participate in this study. Their physiological measurements of pulmonary function and 6-min walking distance, as well as patient-reported measurements of HRQOL, dyspnoea and psychological status, were assessed.
  
  
  RESULTS
  Among these 102 patients, 22 died during a mean follow-up of 11.6 months. The LAS was significantly correlated to mortality (P = 0.0026), although other physiological measurements were not. However, regarding its relationship with HRQOL, correlation coefficients between the LAS, Medical Outcomes Study 36-item short form and St George's Respiratory Questionnaire (SGRQ) were relatively low, with the highest at 0.31. Multivariate analyses showed that the LAS was less significantly related to the SGRQ total score than dyspnoea, and psychological status.
  
  
  CONCLUSIONS
  The LAS was significantly related to mortality in lung transplant candidates in Japan, while, despite its multidimensional scoring, its relationship with health-related quality of life was only weak. Their severity assessment system may be more focused on patients' health and symptoms.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Aoyama
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan hdate@kuhp.kyoto-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000328:Adult; D044466:Asian People; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology* / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014850:Waiting Lists / Q000401:mortality
keywords: Chronic respiratory failure; Health-related quality of life; Lung allocation score; Lung transplantation; Pulmonary function