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Still holding their breath: Mortality on lung transplant wait list remains high for some

Posted Aug 25 2009 6:29pm

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Mortality remains high among patients with pulmonary arterial hypertension awaiting lung transplant, despite changes to the allocation system that were designed to reduce mortality and increase the equitable distribution of donor organs, according to new research out of University of California San Francisco.

The study is reported in the September 1 issue of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Until just a few years ago, the amount of time that a given patient had been on the waiting list was the only factor in determining his or her priority, but in 2005, a new allocation system based on a “lung allocation score” (LAS), was implemented. LAS is determined in part by the patient’s functional status, exercise capacity, lung function, hemodynamic data and the need for ventilatory support.

Overall, mortality on the lung transplant waiting list has fallen as a result of the changes, especially among those with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) and cystic fibrosis (CF); patients with idiopathic pulmonary arterial hypertension (IPAH), however, make up only a small minority of lung-transplant candidates, and therefore little is known about whether and how they have benefited from the changes to lung allocation protocols.

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