초록접수 현황
| 17F-026 | 구연 발표 |
Simulation of Lung Allocation Score (LAS) in a Korean Center and its Implications for the Korean Allocation System
Woo Sik Yu¹, Jee Won Suh², Kyoung Shik Narm², Song Yee Kim³, Moo Suk Park³, Hyo Chae Paik², Jin Gu Lee²
¹Department of Thoracic Surgery, Armed Forces Capital Hospital, Gyeonggi-do, Republic of Korea., ²Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., ³Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : LAS has been used for allocating lung allografts in the United States and Eurotransplant. It is calculated using multiple clinical parameters considering medical urgency and post-transplant survival. The purpose of this study is to evaluate the current urgency based allocation system of Korea by applying LAS to our lung transplant recipients.
Methods : Between October 2012 and July 2016, we reviewed 113 patients performed lung transplant in our hospital retrospectively (Status 0, n=37; Status 1, n=67; Status2/3, n=9). LAS was calculated based on conditions of the recipients at the time of lung transplant in July 2017.
Results : The median waiting times to lung transplant were 76 days in Non-status0 and 11 days in Status0. Among 37 lung transplant candidates at Status0, 19 patients were deteriorated from Non-Status0 in median 64 days (figure A). LAS of our cohort showed bi-modal distribution which was different from unimodal distribution of the United States (Figure B). LAS was 81 ± 11 in Status 0, 47 ±11 in Status 1, 41 ± 8 in Status2/3. There was no significant difference between status 1 and status2/3 in multiple comparison analysis (p=0.416). Hospitalized patients for exacerbation in Non-Status0 has significantly higher LAS than the other status0 (p<0.001) (Figure C).
Conclusion : Recipients in Status0 was under very high LAS at the time of operation, and half of them were deteriorated from Non-Status0 on waiting list. This might increase post-transplant morbidity and mortality. For the best benefit of scarce donated organ, we should consider revising Korean lung distributing system with additional parameters.
Methods : Between October 2012 and July 2016, we reviewed 113 patients performed lung transplant in our hospital retrospectively (Status 0, n=37; Status 1, n=67; Status2/3, n=9). LAS was calculated based on conditions of the recipients at the time of lung transplant in July 2017.
Results : The median waiting times to lung transplant were 76 days in Non-status0 and 11 days in Status0. Among 37 lung transplant candidates at Status0, 19 patients were deteriorated from Non-Status0 in median 64 days (figure A). LAS of our cohort showed bi-modal distribution which was different from unimodal distribution of the United States (Figure B). LAS was 81 ± 11 in Status 0, 47 ±11 in Status 1, 41 ± 8 in Status2/3. There was no significant difference between status 1 and status2/3 in multiple comparison analysis (p=0.416). Hospitalized patients for exacerbation in Non-Status0 has significantly higher LAS than the other status0 (p<0.001) (Figure C).
Conclusion : Recipients in Status0 was under very high LAS at the time of operation, and half of them were deteriorated from Non-Status0 on waiting list. This might increase post-transplant morbidity and mortality. For the best benefit of scarce donated organ, we should consider revising Korean lung distributing system with additional parameters.
첨부파일 : Figure2018_08_16.pptx
책임저자: Jin Gu Lee
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Woo Sik Yu, E-mail : yws081011@gmail.com