Evaluation of Short-Term Outcome after Lung Transplantation in the Lung Allocation Score Era

Thorac Cardiovasc Surg. 2015 Dec;63(8):693-8. doi: 10.1055/s-0034-1387821. Epub 2014 Sep 3.

Abstract

Background: In December 2011, the Eurotransplant Foundation (Leiden, The Netherlands) changed the allocation system for donor lungs from a model based on urgency and waiting time to the lung allocation score (LAS).

Objective: The aim of the study was to investigate the effects of the LAS implementation on the early outcome after lung transplantation in Germany.

Methods: We therefore retrospectively studied the outcome of the last 50 patients transplanted before and the first 50 patients transplanted after LAS implementation.

Results: Both patient groups were comparable in baseline characteristics at the time of transplantation. Postoperative hospital stays were comparable between the groups, that is, 40.3 ± 26.8 and 40.3 ± 31.3 days (p = 0.992). Also, survival rates on intensive care, during entire hospital stay, at 90 days, 6 month, and 1 year after transplant were comparable between the groups. The retrospectively calculated LASs of the patients transplanted under the old allocation system were not statistically significantly different from those after LAS implementation, that is, 46.5 ± 14.2 and 51.2 ± 17.4 (p = 0.139).

Conclusion: We demonstrate, for the first time, that implementation of the LAS in Germany had no negative effect on the early outcome after lung transplantation. Our data indicate that patients transplanted before implementation of the LAS had a similar prospective transplant benefit.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Decision Support Techniques*
  • Female
  • Germany
  • Health Status Indicators*
  • Health Status*
  • Humans
  • Length of Stay
  • Lung Diseases / diagnosis
  • Lung Diseases / mortality
  • Lung Diseases / surgery*
  • Lung Transplantation* / adverse effects
  • Lung Transplantation* / mortality
  • Male
  • Middle Aged
  • Patient Selection*
  • Policy Making
  • Predictive Value of Tests
  • Program Evaluation
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Tissue and Organ Procurement / legislation & jurisprudence*
  • Treatment Outcome
  • Waiting Lists