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Related Concept Videos

Lung Capacity01:47

Lung Capacity

The air in the lungs is measured in volumes and capacities. Lung volume measures reflect the amount of air taken in, released, or left over after a lung function, like a single inhalation. Lung capacity measures are sums of two or more lung volume measures.

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Introduction of the lung allocation score in Germany.

J Gottlieb1, M Greer, U Sommerwerck

  • 1Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|May 24, 2014
PubMed
Summary

Germany's new lung allocation system (LAS) reduced waiting list mortality by 23%, especially for cystic fibrosis and pulmonary hypertension patients. Lung transplants increased, with more idiopathic pulmonary fibrosis recipients and fewer COPD patients.

Keywords:
Lung allocation scorelung transplant outcomelung transplantationwaitlist mortality

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Area of Science:

  • Thoracic Surgery
  • Transplantation Medicine
  • Health Services Research

Background:

  • The introduction of a new lung allocation system (LAS) in Germany aimed to optimize organ distribution.
  • Previous lung allocation systems may not have adequately prioritized patients with specific conditions.
  • Assessing the impact of the LAS on waitlist dynamics and transplant outcomes is crucial for system refinement.

Purpose of the Study:

  • To evaluate the performance of Germany's new lung allocation score (LAS) system.
  • To compare lung transplantation (LTx) activity, waitlist (WL) outflow, and short-term outcomes before and after LAS implementation.

Main Methods:

  • Retrospective analysis of lung transplant data in Germany.
  • Comparison of 1-year periods before and after the LAS introduction on December 10, 2011.
  • Analysis included waitlist registrations, waitlist mortality, transplant activity, recipient demographics, and 3-month post-transplant survival.

Main Results:

  • Waitlist registrations remained stable, but waitlist mortality decreased by 23% (p=0.04) post-LAS.
  • Significant reductions in waitlist mortality were observed for cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), and pulmonary hypertension (PH) patients.
  • Lung transplantation activity increased by 9%, with a shift in recipient composition towards more idiopathic pulmonary fibrosis (IPF) and CF patients, and fewer COPD patients. Transplantation under invasive respiratory support increased significantly in CF patients.

Conclusions:

  • The implementation of the LAS in Germany led to a reduction in waitlist size and mortality.
  • The LAS influenced the composition of lung transplant recipients, prioritizing certain conditions more effectively.
  • Short-term post-transplant survival remained unchanged, indicating sustained quality of care alongside improved allocation efficiency.