ArticleJHLT open2024
Going the distance: Geographic effects of the lung transplant composite allocation score.
Article in JHLT open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Article
- An early nationwide analysis on the continuous distribution of lung-involved multiorgan transplantation.JTCVS open · 2026Article
- Outcomes associated with remote, centralized ex vivo lung perfusion (rc-EVLP) for donor lungs in a real-world setting.JTCVS open · 2025Article
- Preservation of bronchial artery circulation on ex-vivo lung perfusion.Scientific reports · 2025Article
- Impact of the Composite Allocation Score on Lung Transplant Waitlist and Posttransplant Outcomes.Transplantation direct · 2025Article
- Long-term outcomes of the international EXPAND trial of Organ Care System (OCS) Lung preservation for lung transplantation.EClinicalMedicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In March 2023, the lung allocation policy underwent major changes from a tiered structure to a composite allocation score (CAS). The goal was to improve allocation equity for disadvantaged groups by deprioritizing transplant distance. This study examines the effects of CAS on geographic trends and transportation efficiency. Methods: A retrospective cohort study was conducted using the United Network for Organ Sharing database, queried for adult lung transplants from September 1, 2022 to September 1, 2023. Outcomes were nautical distance of transplant, ischemic time, and flight required for transport (estimated as distance >100 miles). Perioperative complications and early survival were analyzed, with propensity matching to account for baseline differences. Results: A total of 1,394 pre-CAS and 1,197 post-CAS patients were included in the study cohort. Post-CAS recipients were less likely to be ABO type O (39.2% vs 47.3%, Conclusions: The lung CAS policy change was intended to eliminate geographic boundaries for disadvantaged patients but has expanded transplant distances, with an expected increase in ischemic time and need for flights which affect transplant economics. Although efforts were made to improve transplant availability for the disadvantaged ABO type O group, early assessment of the recipient cohort showed that recipients with blood group type O were actually less likely to be transplanted under the new policy. Positive effects include an overall decrease in waitlist time, but further investigation is warranted to evaluate the effectiveness, equity, and economic sustainability of the new policy.
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