Those who died on waiting list had lower numerical rankings ascribed by multistate model than Composite Allocation Score
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Oct. 11, 2023 (HealthDay News) — A new model has been developed for prioritizing patients waiting for a lung transplant, according to a study published online Sept. 29 in the American Journal of Respiratory and Critical Care Medicine.
Jarrod E. Dalton, Ph.D., from the Cleveland Clinic, and colleagues examined the effects of accrued wait-list time on mortality in lung transplant candidates and recipients beyond those expressed by worsening clinical status using data for 12,616 Scientific Registry of Transplant Recipients. In addition, a new framework was presented for conceptualizing mortality risk in end-stage lung disease. Trajectories of composite one-year mortality risk were estimated as a function of time from wait-listing to transplant; the predictive accuracy of these estimates was quantified. Multistate model-derived candidate rankings were compared against Composite Allocation Score (CAS) rankings.
The researchers found that 11.5 percent of candidates on the waiting list had predicted mortality risk that increased by >10 percent by day 30. For those who died on the waiting list, lower numerical rankings were ascribed by a multistate model than CAS (mean;median ranking at death: 227;154 for multistate and 329;162 for CAS). Compared with other lung diagnoses, patients with interstitial lung disease were more likely to have increasing risk trajectories as a function of time accrued on the waiting list.
“This approach may allow us to more accurately prioritize time-sensitive lung transplant candidates and decrease waitlist mortality for patients with end-stage lung disease,” Dalton said in a statement.
Copyright © 2023 HealthDay. All rights reserved.
