Proposed scoring system may enhance equity in organ transplantation, increase transplant rates and improve patient survival
Researchers at Cleveland Clinic and Case Western Reserve University (CWRU) have developed a new method that could potentially help provide better access to lung transplants for transplant candidates who are hard to match because of their blood type or height.
An analysis published in the Journal of Heart & Lung Transplantation showed significant inequity in lung transplant access based on these candidate characteristics and proposes a method for addressing it.
Analyzing data for adult lung transplant candidates and donors across the U.S., Cleveland Clinic and CWRU researchers have developed an alternative scoring system for the blood type and height components of the Composite Allocation Score’s biological disadvantage subscore. The approach projects the supply of compatible organs for a given candidate based on the individual’s combination of characteristics. The team then used a new simulation model, which it recently developed and validated, to assess the expected impact of implementing this proposed solution for U.S. patients on the lung transplant waiting list.
While the current Composite Allocation Score considers the effects of blood type and height independently, the research team’s approach of considering blood type and height-based disparities simultaneously provides a more holistic evaluation of biological disadvantage, as candidates can have any combination of these biological characteristics.
Candidates with type-O blood encounter a disadvantage that stems from the fact that they can only accept organs from type-O donors, while type-O organs are compatible for candidates of any ABO blood type. Controlling for height and patients’ medical urgency, the analysis found that type-O candidates had a 37% lower rate of transplant compared with type-A candidates under the current system.
