Lung Allocation Score System: First Italian Experience

A. Palleschi, E. Benazzi, C.F. Rossi, R. Torelli, S.M. Passamonti, C. Pellegrini, A. Lucianetti, P. Tarsia, F. Meloni, P. Parigi, M. Nosotti

Research output: Contribution to journalArticlepeer-review


Background: Lung transplantation is an established therapeutic option for patients with end-stage pulmonary disease. In May 2005, the lung allocation score (LAS) was introduced in the United States to maximize the benefit to the recipient population and reduce waiting list mortality. The LAS has been applied in a region of Italy since March 2016 on a provisional basis. The aims of the study were describing waiting list characteristics and short-term outcomes after lung transplantation before and after LAS introduction. Methods: All the patients who received transplants between January 1, 2011, and March 15, 2017, were included in our retrospective study. The study population was divided into 2 cohorts (historical cohort and post-LAS cohort) and a comparison among the main perioperative data was performed. Results: The historical cohort consisted of 415 patients on the waiting list with 91 deaths and 199 lung transplants; the post-LAS cohort consisted of 134 patients with 10 deaths on the waiting list and 51 transplants. Median waiting time and mortality on the list decreased from 223 to 106 days (P =.03) and from 11.2% to 7.5% (P >.05), respectively. The transplantation rate increased from 25% to 38% (P =.001) and the probability to receive a transplant in the first year in the post-LAS era increased significantly (P =.004). Conclusions: The results of the introduction of the LAS system in our region are encouraging and have not shown any adverse short-term effects. The regional coordination decided to prolong the experimental application of LAS in order to accumulate more data and to evaluate medium-term outcomes.

Original languageEnglish
Pages (from-to)190-193
Number of pages4
JournalTransplantation Proceedings
Issue number1
Publication statusPublished - 2019


  • adult
  • adverse outcome
  • Article
  • cohort analysis
  • comparative study
  • controlled study
  • female
  • hospital admission
  • hospital management
  • human
  • Italy
  • Lung Allocation Score System
  • lung transplantation
  • major clinical study
  • male
  • mortality
  • outcome assessment
  • perioperative period
  • priority journal
  • respiratory tract disease assessment
  • retrospective study
  • waiting time
  • health care organization
  • middle aged
  • procedures
  • supply and distribution
  • transplantation
  • United States
  • Adult
  • Female
  • Health Care Rationing
  • Humans
  • Lung Transplantation
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transplants
  • Waiting Lists


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