Geographic disparities in donor lung supply and lung transplant waitlist outcomes: A cohort study
Geographic disparities in donor lung supply and lung transplant waitlist outcomes: A cohort study
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DOI：
10.1111/ajt.14630
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发表时间：
2018-06-01
影响因子：
8.8
通讯作者：
Arcasoy, Selim M.
中科院分区：
文献类型：
--
作者：
Benvenuto, Luke J.;Anderson, David R.;Arcasoy, Selim M.
尽管美国有公平器官分配的最终规则，但供体肺分配仍存在地域差异，大多数供体肺在当地分配给优先级较低的候选者。我们对 2006 年至 2015 年间候补的 19622 名肺移植候选者进行了一项回顾性队列研究。我们使用多变量调整竞争风险生存模型来检查局部肺可用性与候补结果之间的关系。主要结局是死亡和因临床恶化而从候补名单中除名的复合结果。与最高四分位的候选者相比，当地肺可用率最低四分位数的候补名单候选者的死亡或切除风险增加 84%（子分布风险比 [SHR]：1.84，95% 置信区间 [CI]：1.51-2.24，P
Despite the Final Rule mandate for equitable organ allocation in the United States, geographic disparities exist in donor lung allocation, with the majority of donor lungs being allocated locally to lower-priority candidates. We conducted a retrospective cohort study of 19622 lung transplant candidates waitlisted between 2006 and 2015. We used multivariable adjusted competing risk survival models to examine the relationship between local lung availability and waitlist outcomes. The primary outcome was a composite of death and removal from the waitlist for clinical deterioration. Waitlist candidates in the lowest quartile of local lung availability had an 84% increased risk of death or removal compared with candidates in the highest (subdistribution hazard ratio [SHR]: 1.84, 95% confidence interval [CI]: 1.51-2.24, P