Lung Allocation Score: A Single-Center Simulation.
BACKGROUND
The lung allocation score (LAS) was introduced in the United States in May 2005 with the main goal of reducing the waiting list mortality of patients with end-stage lung diseases, but also to enhance the lung transplant benefit and improve the management of urgent candidates. Several papers have reported that LAS resulted in a reduction of the waiting list mortality but no significant survival benefit was noted.


METHODS
We evaluate the usefulness of LAS as a predictor for lung transplantation outcome in 123 patients listed for lung transplantation in an Italian center. Primary endpoints were waiting list mortality and posttransplant mortality at 1 year; secondary endpoints included perioperative circulatory support, cardiopulmonary bypass, primary graft dysfunction, and long-term survival after transplantation.


RESULTS
We observed the absence of correlation between LAS and waiting list mortality. The LAS did not affect the long-term survival in our population.


CONCLUSIONS
High LAS was predictive of primary graft dysfunction of grade 3 in the first 72 hours after transplantation.
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: lorenzo.rosso@policlinico.mi.it.
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Rosso
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Palleschi
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Tosi
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Mendogni
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Righi
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Carrinola
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Montoli
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Damarco
Respiratory Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Rossetti
Respiratory Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Morlacchi
Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Nosotti
D000328:Adult; D000367:Age Factors; D003550:Cystic Fibrosis / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy; D008171:Lung Diseases / Q000601:surgery*; D008173:Lung Diseases, Obstructive / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D009927:Tissue and Organ Procurement; D014850:Waiting Lists / Q000401:mortality*