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Is the Lung Allocation Score Working? A Qualified: Yes

Stephanie M. Levine, MD, FCCP; Luis F. Angel, MD, FCCP
Author and Funding Information

Correspondence to: Stephanie M. Levine, MD, FCCP, Mail Code 111E, 7400 Merton Minter, San Antonio, TX 78229-3900; e-mail: levines@uthscsa.edu


Dr. Levine is affiliated with the Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio. Dr. Angel is affiliated with the Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, University of Texas Health Science Center at San Antonio.

Dr. Angel is a member of the UNOS Thoracic Organ Transplant Committee. Dr. Levine has reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(4):890-892. doi:10.1378/chest.08-2820
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It has now been over 3.5 years since the allocation of donor lungs has changed from a time-based accrual system (ie, a seniority-based system) to a needs-based allocation system based on disease severity and estimated survival time (ie, priority based). The stimulus for the development of a new system was in part related to the 1999 US Department of Health and Human Services mandate (ie, the Final Rule) regarding organ transplantation.1 The directive required that organ allocation systems had to be constructed based on a balance between predicted waiting list medical urgency and expected posttransplant survival, with the goals of decreasing waiting list mortality, placing priority on medical urgency while avoiding futility, and decreasing the emphasis on waiting times and geography.

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