BACKGROUND: The purpose of the study was to investigate the impact of the lung allocation score (LAS) on mortality among highly urgent (HU) and urgent (U) lung transplant (LTx) candidates in Eurotransplant (ET) and to identify useful additional parameters (LASplus). METHODS: All adult LTx candidates for whom a first request for HU or U status was made in 2008 in ET were included (N = 317). Patients were followed until LTx, death on the waiting list (WL), delisting, or closure date (i.e., January 10, 2010). The relationship between the LAS/LASplus and waiting list, post-transplant, and overall mortality was assessed with a multivariate regression model. The LAS and LASplus were decomposed into their basic waitlist and post-transplant components. RESULTS: Waiting list mortality rate was 22% and 1-year post-transplant mortality rate was 34%. The waitlist component of the LASplus was significantly associated with waiting list mortality (hazard ratio [HR] 1.91, p = 0.021), whereas the LAS was not (p = 0.063). The post-transplant components of both scores were significantly associated with 1-year post-transplant mortality (LAS: HR 2.69, p = 0.005; LASplus: HR 2.55, p = 0.004). Both scores strongly predicted overall mortality (LAS: HR 1.65, p = 0.008; LASplus: HR 1.72, p = 0.005). CONCLUSION: LAS accurately predicts overall mortality in critically ill transplant candidates and should therefore be considered as the basis for a new lung allocation policy in ET. An adjustment of the original LAS may be indicated to accurately predict waiting list mortality.
BACKGROUND: The purpose of the study was to investigate the impact of the lung allocation score (LAS) on mortality among highly urgent (HU) and urgent (U) lung transplant (LTx) candidates in Eurotransplant (ET) and to identify useful additional parameters (LASplus). METHODS: All adult LTx candidates for whom a first request for HU or U status was made in 2008 in ET were included (N = 317). Patients were followed until LTx, death on the waiting list (WL), delisting, or closure date (i.e., January 10, 2010). The relationship between the LAS/LASplus and waiting list, post-transplant, and overall mortality was assessed with a multivariate regression model. The LAS and LASplus were decomposed into their basic waitlist and post-transplant components. RESULTS: Waiting list mortality rate was 22% and 1-year post-transplant mortality rate was 34%. The waitlist component of the LASplus was significantly associated with waiting list mortality (hazard ratio [HR] 1.91, p = 0.021), whereas the LAS was not (p = 0.063). The post-transplant components of both scores were significantly associated with 1-year post-transplant mortality (LAS: HR 2.69, p = 0.005; LASplus: HR 2.55, p = 0.004). Both scores strongly predicted overall mortality (LAS: HR 1.65, p = 0.008; LASplus: HR 1.72, p = 0.005). CONCLUSION:LAS accurately predicts overall mortality in critically ill transplant candidates and should therefore be considered as the basis for a new lung allocation policy in ET. An adjustment of the original LAS may be indicated to accurately predict waiting list mortality.
Authors: Jens Gottlieb; Gregor Warnecke; Johannes Hadem; Martin Dierich; Olaf Wiesner; Thomas Fühner; Martin Strueber; Axel Haverich; Tobias Welte Journal: Intensive Care Med Date: 2012-04-14 Impact factor: 17.440
Authors: Marc Hartert; Omer Senbaklavacin; Bernhard Gohrbandt; Berthold M Fischer; Roland Buhl; Christian-Friedrich Vahld Journal: Dtsch Arztebl Int Date: 2014-02-14 Impact factor: 5.594
Authors: Shampa Chatterjee; Gary F Nieman; Jason D Christie; Aron B Fisher Journal: Am J Physiol Lung Cell Mol Physiol Date: 2014-09-19 Impact factor: 5.464
Authors: Jens Gottlieb; Jacqueline Smits; Rene Schramm; Frank Langer; Roland Buhl; Christian Witt; Martin Strueber; Hermann Reichenspurner Journal: Dtsch Arztebl Int Date: 2017-03-17 Impact factor: 5.594
Authors: Stephanie Klinzing; Giovanna Brandi; Dimitri A Raptis; Urs Wenger; Denise Weber; Paul A Stehberger; Ilhan Inci; Markus Béchir Journal: Transplant Res Date: 2014-04-01