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  • ^ Kern, Dayle: "Advocates at Work: Unique Team Responds to Transplant Inequities for PH Patients", article on page 7 of the Winter 2007 Pathlight newsletter of the Pulmonary Hypertension Association.
  • ^ Grady, Denise: "Updated Rules Shorten Waits For New Lungs", article in the September 23, 2006 issue of The New York Times.
  • References

    • United Network for Organ Sharing

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    Lung allocation score

    Article Id: WHEBN0007637500
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    Title: Lung allocation score  
    Author: World Heritage Encyclopedia
    Language: English
    Subject: Lung transplantation, Editor review/Tachikoma, LAS, Pulmonology, Transplantation medicine
    Collection: Pulmonology, Surgery, Transplantation Medicine
    Publisher: World Heritage Encyclopedia
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    Lung allocation score

    The lung allocation score (LAS) is a numerical value used by the lung transplant.

    The LAS system replaces the older method within the United States of allocating donated lungs strictly on a first-come, first-served basis, according to blood type compatibility and distance from the donor hospital. The older method is still used for patients under the age of 12.

    The LAS system is still being evaluated and revised.[1] The reason for this continuing analysis is the need to balance on one hand the desire to help those patients in direct need, versus the statistical likelihood of the patient to survive the procedure, as well as the post-operative risks of infection and transplant rejection.[2]

    Contents

    • Lung allocation scoring method 1
      • Factors in calculating the LAS 1.1
    • How the LAS score is used 2
      • Illustrative example 2.1
    • Notes 3
    • References 4

    Lung allocation scoring method

    The lung allocation score is calculated from a series of formulas that take into account the statistical probability of a patient's survival in the next year without a transplant, and the projected length of survival post-transplant. A raw allocation score, summarizing all of the above values, is calculated, and finally this score is normalized to obtain the actual LAS, which has a range from 0 to 100. Higher lung allocation scores indicate the patient is more likely to benefit from a lung transplant.

    Factors in calculating the LAS

    There are many factors that are used to calculate the lung allocation score:

    UNOS requires that the various medical results must be current, i.e. obtained within the last six months, or the relevant factor is assigned a zero value. Exceptions can be made if a patient is deemed unable to complete a test due to his or her current condition. In such a case, the physician must obtain permission from the UNOS Lung Review Board to submit a reasonable estimate of how the patient would perform.

    In certain instances, a physician may petition the UNOS Lung Review Board to modify a patient's assigned LAS if it is felt that a patient's particular circumstances are not adequately represented by the regular LAS calculation system.

    How the LAS score is used

    The lung allocation score is an important part of the recipient selection process, but other factors are also considered. Patients who are under the age of 12 are still given priority based on how long they have been on the transplant waitlist. The length of time spent on the list is also the deciding factor when multiple patients have the same lung allocation score.

    • Blood type compatibility
      The blood type of the donor must match that of the recipient due to certain

      Notes

      A lung from a 16-year-old donor would first be offered to the person in the age group 12-17 with the highest lung allocation score and matching blood type in the vicinity of the transplant center. If there no suitable recipient in that age group, it would next be offered to the highest LAS-scoring candidate who is under 12 years of age. Finally, it would be offered to the highest LAS-scoring person of age 18 or older. If there is no suitable candidate within the area, the lung may be offered to someone farther away, within certain time and distance constraints.

      Illustrative example

      • Distance from the donor hospital
        As donated lungs should be transplanted into the recipient within four to six hours of recovery, ideally both donor and transplant hospitals should be relatively near each other.
    3rd priority candidate age 18+ age 18+
    2nd priority candidate age 12-17 age <12 age <12
    1st priority candidate age <12 age 12-17 age 18+
    Donor age <12 Donor age 12-17 Donor age 18+
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