Refine Lung Data Fields

At a glance

Current policy

The Lung Allocation Score (LAS) is used to rank candidates for lung offers and is made up of different clinical factors of a lung transplant candidate. This includes factors such as the transplant candidate’s body mass index (BMI) and what they have been diagnosed with. Changes to the lung allocation score (LAS), “Updated Cohort for Calculation of the Lung Allocation Score (LAS),” were approved winter 2020 at the OPTN Board of Directors Meeting and are planned for implementation in the fall of 2021.

Supporting media

Presentation

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Proposed changes

This proposal clarifies data entry and the impact of specific diagnoses for LAS as it relates to the changes pending fall 2021 implementation. These proposed changes are related to the use of body mass index (BMI), pulmonary fibrosis, and bronchiolitis in the LAS.

• Body Mass Index (BMI)
  • Add separate date collected fields for the candidate’s values for height and for weight
  • Update policy to only require weight to be updated every six months
• Diagnoses
  • Consolidate diagnosis option for “secondary pulmonary fibrosis” into “Pulmonary fibrosis: other specify cause”
  • Clarify that the diagnoses “pulmonary fibrosis: other” and “COVID-19: pulmonary fibrosis" use the same coefficient in the LAS calculation
  • Clarify that the diagnoses “obliterative bronchiolitis” and “constrictive bronchiolitis” use the same coefficient in the LAS calculation
• Pulmonary Artery (PA) Pressure
  • Clarify that if the value for “mean PA pressure” is missing for a candidate, the value will be assumed to be 30 or less
• Label consistency
  • Align names of three diagnosis codes between policy and UNet^SM

Anticipated impact

• What it's expected to do
  • Improve the consistency and accuracy of lung candidate data
  • Change certain candidates LAS scores

• What it won't do
  • Change how the LAS is calculated

Themes

• Data consistency
• Record maintenance

Terms to know

• Lung Allocation Score: In the OPTN lung allocation system, every lung transplant candidate age 12 and older receives a lung allocation score. The LAS is used with blood type and the distance between the candidate and the donor hospital to determine priority for receiving a lung transplant. The score is made up of factors that help determine a candidate’s waitlist urgency and post-transplant survival.
• Body Mass Index (BMI): A measure of body size, calculated as weight in kilograms divided by height in meters squared.
• Pulmonary Fibrosis: A lung disease that results in lung tissue being damaged and scarred.
• Constrictive Bronchiolitis/Obliterative Bronchiolitis: A disease that results in obstruction of the smallest airways of the lungs due to inflammation.
• Coefficient: A number used to multiply a variable.
• Click here to search the OPTN glossary