Egan T M, Murray S, Bustami R T, Shearon T H, McCullough K P, Edwards L B, Coke M A, Garrity E R, Sweet S C, Heiney D A, Grover F L
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Transplant. 2006;6(5 Pt 2):1212-27. doi: 10.1111/j.1600-6143.2006.01276.x.
This article reviews the development of the new U.S. lung allocation system that took effect in spring 2005. In 1998, the Health Resources and Services Administration of the U.S. Department of Health and Human Services published the Organ Procurement and Transplantation Network (OPTN) Final Rule. Under the rule, which became effective in 2000, the OPTN had to demonstrate that existing allocation policies met certain conditions or change the policies to meet a range of criteria, including broader geographic sharing of organs, reducing the use of waiting time as an allocation criterion and creating equitable organ allocation systems using objective medical criteria and medical urgency to allocate donor organs for transplant. This mandate resulted in reviews of all organ allocation policies, and led to the creation of the Lung Allocation Subcommittee of the OPTN Thoracic Organ Transplantation Committee. This paper reviews the deliberations of the Subcommittee in identifying priorities for a new lung allocation system, the analyses undertaken by the OPTN and the Scientific Registry for Transplant Recipients and the evolution of a new lung allocation system that ranks candidates for lungs based on a Lung Allocation Score, incorporating waiting list and posttransplant survival probabilities.
本文回顾了于2005年春季生效的美国新肺脏分配系统的发展历程。1998年，美国卫生与公众服务部的卫生资源与服务管理局发布了《器官获取与移植网络（OPTN）最终规则》。根据该于2000年生效的规则，OPTN必须证明现有的分配政策符合某些条件，或者改变政策以满足一系列标准，包括更广泛的器官地理共享、减少将等待时间用作分配标准，以及使用客观医学标准和医疗紧迫性来创建公平的器官分配系统，以便为移植分配捐赠器官。这一要求导致对所有器官分配政策进行审查，并促成了OPTN胸科器官移植委员会肺脏分配小组委员会的成立。本文回顾了该小组委员会在确定新肺脏分配系统的优先事项方面的审议情况、OPTN和移植受者科学登记处进行的分析，以及基于肺脏分配评分对肺脏候选者进行排名的新肺脏分配系统的演变，该评分纳入了等待名单和移植后存活概率。
