Validating thoracic simulated allocation model predictions for impact of broader geographic sharing of donor lungs on transplant waitlist outcomes.
J Heart Lung Transplant
; 39(5): 433-440, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-31813759
ABSTRACT
BACKGROUND:
The thoracic simulated allocation model (TSAM) is used by the Scientific Registry of Transplant Recipients to predict the relative effect of organ allocation policy changes. A new lung allocation policy changing the first unit of allocation from donation service area to 250 nautical miles took effect on November 24, 2017. We studied TSAM's ability to correctly predict trends caused by changes in allocation policy.METHODS:
We compared the population characteristics from the TSAM cohort, 6,386 lung transplant candidates from 2009 to 2011, with the observed cohort of 7,601 candidates from the year before the policy change on November 24, 2017, and the year after. Simulations were run 10 times. Waitlist mortality and transplant rates were calculated and compared with observed mortality and transplant rates in the years before and after the policy change.RESULTS:
TSAM correctly predicted no change in overall waitlist mortality or transplant rates with the policy change. Observed waitlist mortality values were higher, as were transplant rates, because of increased organ donation and population change. TSAM predicted increased transplant rates for diagnosis group D (idiopathic pulmonary fibrosis), decreased rates for group A (chronic obstructive pulmonary disease), and increased rates for candidates with lung allocation score ≥50, but these changes did not occur in the waitlist and transplant populations after the policy change.CONCLUSIONS:
TSAM correctly predicted the relative trends caused by a change in allocation policy but smaller sub-group predictions were not seen.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
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Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Doadores de Tecidos
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Obtenção de Tecidos e Órgãos
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Listas de Espera
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Transplante de Pulmão
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Alocação de Recursos
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Heart Lung Transplant
Assunto da revista:
CARDIOLOGIA
/
TRANSPLANTE
Ano de publicação:
2020
Tipo de documento:
Article