39th National Congress of the Italian Society of Organ TransplantationThoracic transplantationLung Allocation Score: A Single-Center Simulation

•In our case series, LAS returned conflicting results for waiting list mortality; even though not statistically significant, the third LAS quartile had the highest mortality but the fourth quartile the lowest.•We observed the absence of correlation between LAS and waiting list mortality; patients with LAS ranging from 39 to 60 had a 1-year mortality rate higher than those who had LAS of ≤38.•The LAS did not affect the long term survival in our population. The cluster of patients with LAS >60 did not have an increased risk of death at 1 year as well as beyond that limit.•High LAS was predictive of primary graft dysfunction of grade 3 in the first 72 hours after transplantation.

BackgroundThe lung allocation score (LAS) was introduced in the United States in May 2005 with the main goal of reducing the waiting list mortality of patients with end-stage lung diseases, but also to enhance the lung transplant benefit and improve the management of urgent candidates. Several papers have reported that LAS resulted in a reduction of the waiting list mortality but no significant survival benefit was noted.MethodsWe evaluate the usefulness of LAS as a predictor for lung transplantation outcome in 123 patients listed for lung transplantation in an Italian center. Primary endpoints were waiting list mortality and posttransplant mortality at 1 year; secondary endpoints included perioperative circulatory support, cardiopulmonary bypass, primary graft dysfunction, and long-term survival after transplantation.ResultsWe observed the absence of correlation between LAS and waiting list mortality. The LAS did not affect the long-term survival in our population.ConclusionsHigh LAS was predictive of primary graft dysfunction of grade 3 in the first 72 hours after transplantation.