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The lung allocation score could evaluate allocation systems in countries that do not use the score

Authors
 Woo Sik Yu  ;  Jee Won Suh  ;  Seung Hwan Song  ;  Hyo Chae Paik  ;  Song Yee Kim  ;  Moo Suk Park  ;  Jin Gu Lee 
Citation
 PLOS ONE, Vol.14(4) : e0214853, 2019 
Journal Title
 PLOS ONE 
Issue Date
2019
Abstract
BACKGROUND: Evaluating allocation system effects on lung transplantation and determining systemic flaws is difficult. The purpose of this study was to assess the Korean urgency-based lung allocation system using the lung allocation score. METHODS: We reviewed transplantation patients retrospectively. Candidates were classified into groups based on urgency. Status 0 designated hospitalized patients requiring ventilator and/or extracorporeal life support. The lung allocation score was calculated based on the recipient's condition at transplantation. RESULTS: One-hundred-twenty-three Status 0, 1, and 2/3 patients (40, 71, and 12, respectively) were enrolled. The median waiting time was 68 days. Nineteen Status 0 patients who received lung transplants deteriorated from non-Status 0 (median, 64 days). The lung allocation score showed a bimodal distribution (peaks around 45 and 90, corresponding with non-Status 0 and Status 0, respectively). Status 0 and the lung allocation score were independent risk factors for poor survival after adjustment for confounders (Status 0, hazard ratio, 2.788, p = 0.001; lung allocation score, hazard ratio, 1.025, p < 0.001). The lung allocation score cut-off for survival was 44. On dividing the non-Status 0 patients into 2 groups using the cut-off values and regrouping into Status 0, non-Status 0 with high lung allocation score (> 44), and non-Status 0 with low lung allocation score (< 44), we observed that non-Status 0 with high lung allocation score patients had better survival than Status 0 patients (p = 0.020) and poorer survival than non-Status 0 with low lung allocation score patients (p = 0.018). CONCLUSIONS: The LAS demonstrated the characteristics of LTx recipients in Korea and the Korean allocation system needs to be revised to reduce the number of patients receiving LTx in Status 0. The LAS system could be used as a tool to evaluate lung allocation systems in countries that do not use the LAS system.
DOI
10.1371/journal.pone.0214853
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Song, Seung Hwan(송승환)
Lee, Jin Gu(이진구)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169890
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