Maryam Valapour, M.D., Director of Lung Transplant Outcomes at Cleveland Clinic, is the primary author of the study. Dr. Valapour also serves as the Senior Investigator for Lung Transplantation for the Scientific Registry of Transplant Recipients, the organization responsible for analyzing U.S. transplant data.
Lung Allocation Score system first aligns compatibility for candidates within a 250-mile radius, sometimes resulting in an inefficient distribution of organs based on geographical restriction. Under this current system, sicker patients who live just outside the 250-mile radius may lose out on a life-saving transplant because of where they live.
The new Composite Allocation Score system was developed to improve equity in organ allocation by eliminating geographical boundaries and prioritizing the candidate’s medical needs. This system is expected to set a precedent for the Organ Procurement and Transplantation Network and United Network for Organ Sharing (UNOS) for all organs, with lungs being the first organ allocation system to undergo this change.
“The importance of removing the geographical barrier can’t be overstated here,” said Dr. Valapour. “The Composite Allocation Score system’s goal of making access to lung transplant more equitable for all candidates in the United States will help reduce waitlist mortality and we hope will even improve post-transplant survival over time.”
To understand the potential effects on lung transplant candidates waiting for organs, the research team tested six alternative scenarios over 10 simulations using data from individuals on the lung transplant waiting list from Jan. 1, 2018, through Dec. 31, 2019. Depending on the scenario tested, waitlist deaths decreased by 36% to 47% in the Composite Allocation Score system as compared to the current system.
“With more candidates added to the waitlist every day, access to available lungs is incredibly important,” says study co-author, Carli Lehr, M.D., a pulmonary and critical care physician at Cleveland Clinic. “The Composite Allocation Score system will help those on the waitlist overcome challenges associated with their proximity to potential donors.”
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