Lung Transplants Do Not Go to Those Most in Need

Lung transplants were based on location and not need

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Unfortunately many people who need a lung transplant die waiting. This might be different if transplants were given based on need and not on location.

The current transplant system gives lungs to the closest available patient and not to a regional patient with the most need.

According to the data, this could reduce the effectiveness of lung transplants and has led to an increase in the number of patients dying while waiting for a lung transplant.

"Ask your doctor about transplants in your region. "

The study used data from the United Network for Organ Sharing (UNOS) and was led by Mark J. Russo, M.D., M.S., from the University of Chicago. Among 580 double-lung transplants performed in 2009 that were based on location, 480 less needy patients received a transplant when another candidate with greater need was in the same region.

By focusing on need and not location, less people will die while waiting for a lung transplant.

Researchers used a lung allocation score (LAS), with a range from 1 to 100 with a higher number representing a greater need and possible benefit. Out of the 580 transplants, 24 percent of the transplants did not go to a patient with a LAS score 10 points higher than the local recipient.

More than seven percent of the transplants did not go to a patient with a LAS score 25 points higher than the local recipient.

Unfortunately, 180 patients died while waiting for a lung transplant.

The United States Department of Health and Human Services created the “Final Rule” policy. This policy was intended to make sure transplants were given to those based on medical need and not geography. According to the researchers, the data shows that the location of a patient continues to be a factor in determining who gets a transplant.

Previous research by Dr. Russo showed that 82 percent of lung transplants went to individuals who had a LAS score of less than 50. For patients with a LAS score of under 50, a five-year life expectancy is better than 50 percent. A higher LAS score means that a patient is likely to live for five years and chances are likely will only live for a few months without a lung transplant.

Some limitations of the study included only considering double-lung transplants as well as not factor in national matching or crossing blood groups. According to Dr. Russo, these limitations probably underestimates the numbers reported and that there is a possibility more transplants are going to less-needy individuals based on location.

Because there are not enough transplants to meet the demand is important to understand who needs a transplant the most. Efficiently allocating transplants will lead to more people living longer according to Dr. Russo.

This study was presented at the annual meeting of the Society of Thoracic Surgeons. Research findings are considered preliminary until they are published in a peer-reviewed journal.

No funding information was published. No author conflicts were reported.

Reviewed by: 
Review Date: 
February 2, 2012
Last Updated:
February 2, 2012