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OPTN/SRTR 2011 Annual Data Report: lung
M Valapour1, K Paulson, J M Smith
1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
Summary
Lung Allocation Score (LAS) implementation led to increased wait-list additions and mortality, but also improved graft survival. Pediatric lung transplant wait-lists have declined, with ongoing improvements in survival rates.
Area of Science:
- Pulmonology and Transplant Medicine
- Public Health Policy
- Organ Allocation Systems
Background:
- The Lung Allocation Score (LAS) was implemented to optimize lung transplant candidate allocation.
- Post-LAS, there has been a notable increase in wait-list additions, particularly among older adults.
- Transplant and donation rates have not matched the pace of increasing wait-list additions.
Purpose of the Study:
- To analyze trends in lung transplant wait-list dynamics and outcomes following LAS implementation.
- To evaluate changes in wait-list mortality and graft/patient survival rates.
- To assess pediatric lung transplant trends and outcomes.
Main Methods:
- Analysis of national lung transplant wait-list data.
- Comparison of pre- and post-LAS implementation metrics.
- Evaluation of graft and patient survival rates over a decade.
Main Results:
- Wait-list additions increased significantly post-LAS, with older adults (≥65 years) showing the fastest growth.
- Wait-list mortality rose to 15.7 per 100 wait-list years in 2011.
- Short- and long-term graft survival improved, with 10-year graft failure reaching an all-time low.
- Pediatric wait-list additions declined, and pediatric lung transplants showed improved survival rates.
Conclusions:
- While LAS improved graft survival, it coincided with increased wait-list additions and mortality.
- Pediatric lung transplant wait-lists have decreased, with continued improvements in survival.
- Post-transplant complications remain a concern for both adult and pediatric recipients.
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