New mathematical modeling system for organ allocation

Apr 26 2007

The International Society for Heart and Lung Transplantation (ISHLT) announces evaluation of a new mathematical modeling system for lung allocation in the United States and the ethical issues surrounding organ allocation facing patients awaiting transplants.

Both will be discussed at its 27th Annual Meeting and Scientific Sessions, today in Satellite Symposium 9, Continued Evaluation of Heart and Lung Allocation Using Evidence Based Research.

Worldwide, patients in need of transplant are placed on a waiting list for donor lungs, using a wide variety of systems. In the United States, patients are currently assessed for organ allocation based on a new mathematical modeling system, in which patient information is entered into a computer database and donors are then matched with recipients based on specific characteristics. Two of the most important criteria are the chance of survival without the transplant and the projected condition of the patient post transplant. The computer program then generates a list of patients that are ranked according to preset organ allocation policies. Once selected, there are a number of tests that must be performed in order to evaluate whether the recipient may in fact receive the organ. Taking into consideration the novelty of the system, an international representation of ISHLT membership will convene to evaluate this new modeling system to determine its effectiveness and Leah Edwards, Ph.D., United Network for Organ Sharing, will present How is the Lung Allocation Score Working in the US? during the Symposium.

"Many patients, families and those within the medical community have considered a first-come, first-served allocation system to be unfair, given that it did not take into account factors such as severity of a particular disease or how likely a patient would be to survive the transplant. This new system is an effort to give every patient an equal chance at transplant based on a number of varying factors," said Tom Waddell, M.D., Division of Thoracic Surgery, Toronto General Hospital, Canada and ISHLT Program Committee Member.

James DuBois, Ph.D., DSc, St. Louis University, St. Louis, MO, will discuss Ethical Issues in Organ Allocation/Solicitation, today at 11:15am PDT during the Symposium. Friday during the morning plenary session, John Dark, MB, FRCS, Newcastle Upon Tyne, United Kingdom will present Controversies and Ethical Dilemmas in Thoracic Organ Allocation. Discussions will focus not only on the effectiveness of the new system in the US, but compare the systems used in Europe and elsewhere.

"While some people argue that survivorship should be central in the choice for organ allocation, others argue that each patient should get a fair chance at receiving the organ. During this session, we will evaluate how systems used around the world create an equal and ethical playing field for all patients," Dr. Waddell continued.

Dirk van Raemdonck, MD, PhD, University Hospital Gasthuisberg, Leuven, Belgium will provide an update on the status of organ allocation in Europe in his presentation Issues in Heart and Lung Allocation in East and West Europe at 11:00am PDT.