title: The University of Minnesota Donor Lung Quality Index: A Consensus-Based Scoring Application Improves Donor Lung Use.
abstract: BACKGROUND
  A simplified and consensus-based donor scoring process could improve donor lung use.
  
  
  METHODS
  To develop the University of Minnesota Donor Lung Quality Index (UMN-DLQI), we used expert opinion to create an online survey that ranked 17 lung donor and recipient factors and graded their importance on a scale of 0 to 10. To arrive at consensus-based weights for each of the 17 factors, we used magnitude estimation (ME) methods. We performed receiver operating characteristic (ROC) analyses to evaluate predictive value. An application (app) was developed to simplify the scoring process. A second review process was instituted for every donor offer with an UMN-DLQI score greater than 40 as of September 2014 (post-donor score era).
  
  
  RESULTS
  Worldwide, 11 transplantation centers (including ours) completed our survey. Results showed strong consensus among transplantation physicians across disparate practices. UMN-DLQI scores greater than 40 provided a sensitivity of 89%, a specificity of 55%, and a positive predictive value of 52% for donor offer acceptance. Number of transplants (63 versus 48) and donor lung use (15.1% versus 8.9%; p = 0.02) were significantly better in the post-donor score era without a penalty in transplantation outcomes. There was a trend toward a lower incidence of any primary graft dysfunction within 72 hours (40% versus 75%; p = 0.06) with a UMN-DLQI greater than 40 but no difference in 30-day or 1-year survival.
  
  
  CONCLUSIONS
  The UMN-DLQI scoring app is a simple tool for describing the attributes of a donor lung offer. More attention to scores greater than 40 safely improved donor lung use at a single institution.
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota. Electronic address: gloor@umn.edu.
authors: Gabriel
authors: G
authors: Loor
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: David M
authors: DM
authors: Radosevich
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: Rosemary F
authors: RF
authors: Kelly
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: Irena
authors: I
authors: Cich
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: Timothy S
authors: TS
authors: Grabowski
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: Christopher
authors: C
authors: Lyon
authors: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors: J
authors: J
authors: Michael Morrow
authors: Department of Cardiothoracic Surgery, St. Francis Heart Institute, Cape Girardeau, Missouri.
authors: Edward M
authors: EM
authors: Bender
authors: Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors: Joanne
authors: J
authors: Billings
authors: Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors: Marshall
authors: M
authors: Hertz
mesh_terms: D000046:Academic Medical Centers; D032921:Consensus; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008910:Minnesota; D063731:Mobile Applications / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012372:ROC Curve; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*