High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation
High Lung Allocation Score Is Associated With Increased Morbidity and Mortality Following Transplantation
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DOI：
10.1378/chest.09-0319
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发表时间：
2010-03-01
期刊：
影响因子：
9.6
通讯作者：
Sonett, Joshua R.
中科院分区：
文献类型：
--
作者：
Russo, Mark J.;Iribarne, Alexander;Sonett, Joshua R.
背景：肺分配评分（LAS）于2005年5月启动，用于根据医疗紧急情况和移植后存活率分配肺。这项研究的目的是确定是否有一个升高之间的关联。LAS在移植时，增加术后发病率和mortals.Methods：器官共享的联合网络提供了去识别的患者水平的数据。分析包括年龄≥ 12岁的肺移植受者，他们在2006年4月5日至2007年12月31日期间接受了移植（n = 3，836）。接受者分为三组：LAS < 50（n = 3，161，83.87%），LAS 50 - 75（n = 411，10.9%）和LAS ≥ 75（n = 197，5.23%），分别称为低LAS（LLAS），中等LAS（ILAS）和高LAS（HLAS）。主要结果是移植后1年的移植物存活率。次要结果包括住院时间和住院并发症。结果：HLAS受体在90天和1年的精算生存率明显低于LLAS受体。当移植受者按疾病病因分层时，在肺移植的所有主要原因中观察到生存率降低伴LAS升高的趋势。与LLAS受者相比，HLAS受者更可能需要透析或发生感染（P
Background: The lung allocation score (LAS) was initiated in May 2005 to allocate lungs based on medical urgency and posttransplant survival. The purpose of this study was to determine if there is an association between an elevated. LAS at the time of transplantation and increased postoperative morbidity and mortality.Methods: The United Network for Organ Sharing provided de-identified patient-level data. Analysis included lung transplant recipients aged >= 12 years who received transplants between April 5, 2006, and December 31, 2007 (n = 3,836). Recipients were stratified into three groups: LAS < 50 (n = 3,161, 83.87%), LAS 50 to 75 (n = 411, 10.9%), and LAS >= 75 (n = 197, 5.23%), referred to as low LAS (LLAS), intermediate LAS (ILAS), and high LAS (HLAS), respectively. The primary outcome was posttransplant graft survival at 1 year. Secondary outcomes included length of stay and in-hospital complications.Results: HLAS recipients had significantly worse actuarial survival at 90 days and I year compared with LLAS recipients. When transplant recipients were stratified by disease etiology, a trend of decreased survival with elevated LAS was observed across all major causes of lung transplant. HLAS recipients were more likely to require dialysis or to have infections compared with LLAS recipients (P