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Urgent lung allocation system in the Scandiatransplant countries

Auråen, Henrik; Schultz, Hans Henrik L.; Hämmäinen, Pekka; Riise, Gerdt C.; Larsson, Hillevi LU ; Hansson, Lennart LU ; Dellgren, Göran; Perch, Michael; Geiran, Odd and Fiane, Arnt E., et al. (2018) In Journal of Heart and Lung Transplantation 37(12). p.1403-1409
Abstract

BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year. This study aims to explore the characteristics and outcome of patients listed as urgent, assess changes associated with the implementation of ScULAS, and describe how the system was utilized by the member centers.... (More)

BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year. This study aims to explore the characteristics and outcome of patients listed as urgent, assess changes associated with the implementation of ScULAS, and describe how the system was utilized by the member centers. METHODS: All patients listed for lung transplantation at the 5 Scandiatransplant centers 5 years before and after implementation of ScULAS were included. RESULTS: After implementation, 8.3% of all listed patients received urgent status, of whom 81% were transplanted within 4 weeks. Patients listed as urgent were younger, more commonly had suppurative lung disease, and were more often on life support compared with patients without urgent status. For patients listed as urgent, post-transplant graft survival was inferior at 30 and 90 days. Although there were no pre-defined criteria for urgent listing, the system was not utilized at its maximum. CONCLUSIONS: ScULAS rapidly allocated organs to patients considered urgent. These patients were younger and more often had suppurative lung disease. Patients with urgent status had inferior short-term outcome, plausibly due to the higher proportion on life support before transplantation.

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Contribution to journal
publication status
published
subject
keywords
allocation, lung, scandiatransplant, transplantation, urgency
in
Journal of Heart and Lung Transplantation
volume
37
issue
12
pages
1403 - 1409
publisher
Elsevier
external identifiers
  • scopus:85053727736
ISSN
1053-2498
DOI
10.1016/j.healun.2018.08.002
language
English
LU publication?
yes
id
2120d75c-30d9-4528-9b5a-b6819c23fbb6
date added to LUP
2018-11-06 15:15:05
date last changed
2019-05-21 04:14:24
@article{2120d75c-30d9-4528-9b5a-b6819c23fbb6,
  abstract     = {<p>BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year. This study aims to explore the characteristics and outcome of patients listed as urgent, assess changes associated with the implementation of ScULAS, and describe how the system was utilized by the member centers. METHODS: All patients listed for lung transplantation at the 5 Scandiatransplant centers 5 years before and after implementation of ScULAS were included. RESULTS: After implementation, 8.3% of all listed patients received urgent status, of whom 81% were transplanted within 4 weeks. Patients listed as urgent were younger, more commonly had suppurative lung disease, and were more often on life support compared with patients without urgent status. For patients listed as urgent, post-transplant graft survival was inferior at 30 and 90 days. Although there were no pre-defined criteria for urgent listing, the system was not utilized at its maximum. CONCLUSIONS: ScULAS rapidly allocated organs to patients considered urgent. These patients were younger and more often had suppurative lung disease. Patients with urgent status had inferior short-term outcome, plausibly due to the higher proportion on life support before transplantation.</p>},
  author       = {Auråen, Henrik and Schultz, Hans Henrik L. and Hämmäinen, Pekka and Riise, Gerdt C. and Larsson, Hillevi and Hansson, Lennart and Dellgren, Göran and Perch, Michael and Geiran, Odd and Fiane, Arnt E. and Iversen, Martin and Holm, Are Martin},
  issn         = {1053-2498},
  keyword      = {allocation,lung,scandiatransplant,transplantation,urgency},
  language     = {eng},
  number       = {12},
  pages        = {1403--1409},
  publisher    = {Elsevier},
  series       = {Journal of Heart and Lung Transplantation},
  title        = {Urgent lung allocation system in the Scandiatransplant countries},
  url          = {http://dx.doi.org/10.1016/j.healun.2018.08.002},
  volume       = {37},
  year         = {2018},
}