In 2005, the U.S. Organ Procurement and Transplantation Network (OPTN) and its non-profit funding agency, United Network for Organ Sharing (UNOS), changed the nation's method of allocating organs to transplant candidates. The new method, involving a scoring system to help determine position on the organ waiting list, replaced an older system allocating organs on a first-come first-serve basis.
Under the new lung allocation system, every lung transplant candidate age 12 and older receives an individualized lung allocation score. The lung allocation score reflects both the seriousness of each candidate's medical status before transplant and the likelihood of a successful transplant. It is an important factor in determining priority for receiving a lung transplant when a donor lung becomes available. The system determines the order of everyone awaiting a lung transplant by their lung allocation scores, blood type, and the geographic distance between the candidates and the hospital where the lung donor is located. Age also plays a role because lungs from pediatric and adolescent donors are now offered first to pediatric and adolescent candidates before they are offered to adults.
The score utilizes a complex clinical calculator derived from clinical predictors of survival that is reported on a scale of 0 to 100 (0 is least ill and 100 is the most ill). In the first year the new system was in place, over half of lung transplants were performed in patients with scores less than or equal to 40. Additional information on transplants performed each year is available through the published reports at the Organ Procurement and Transplantation (OPTN) website, optn.transplant.hrsa.gov. Click here to read more about the LAS and the clinical indicators used to determine a patient's individual LAS score
OPTN maintains a centralized computer network linking all transplant centers and regional organ procurement organizations (OPOs), which identify potential organs for transplant and coordinate with the national network. This computer system is accessible 24 hours a day, seven days a week, with organ placement specialists available round the clock. The OPO for this region is the New York Organ Donor Network.
In the New York region, most lung transplant candidates wait from 10 to 14 months for the appropriate donor organ(s) to become available. During your wait, it is critical for you to maintain good nutrition and keep up rehabilitation efforts under the care of your local physician. Most transplant recipients will tell you that this waiting time was the most difficult part of their entire transplant experience. The transplant coordinator and social worker serve as your advocates, recommending and facilitating the support services you may require.
Additional questions regarding the LAS score and your status on the wait list should be directed to your transplant pulmonologist or coordinator.