TY  - JOUR
AU  - Afshar, Kamyar
AU  - Bremer, Michelle
AU  - Kurup, Deepa
AU  - Bernales, Michael
AU  - Schonhoft, Elizabeth
AU  - Santana, Luis
AU  - Davila, Caro
AU  - Schooler, Gina
AU  - Yung, Gordon
AU  - Pollema, Travis
AU  - Golts, Eugene
PY  - 2023
DA  - 2023/03/14
TI  - Monitoring Survival Following Lung Transplantation with Inclusion of Unaccounted Risks
JO  - OBM Transplantation
SP  - 177
VL  - 07
IS  - 01
AB  - Lung transplant (LTx) survival and quality of life have been steadily improving, partially from changes in candidate selection for transplantation. There are well-known high-risk factors that lead to poor LTx outcomes, which may be referred to as ‘accounted’ risks. However, there are also other ‘unaccounted’ risks that are not included in the existing model for expected LTx survival to help programs for resource allocation. We performed a retrospective cohort study of all LTx recipients over the age of 18 at UC San Diego Health between June 2019 and March 2021. Patient’s ‘unaccounted’ risks were identified as low, moderate, or high risk in 4 discrete categories: Medical, Surgical, Psychosocial and Nutritional. The risks were entered into a software tool that calculated an 'unaccounted' risk adjusted observed to expected ratio (O:E), using calculations that mirror the Scientific Registry of Transplant Recipients (SRTR) risk-calculation methodology at the same six month intervals, termed Program-Specific Report (PSR) cycles. During the study period, 65 patients underwent lung transplantation. Of those, 25 had at least one high ‘unaccounted’ risk. The ‘unaccounted’ risk-adjusted O:E was 1.54 while the observed O:E was 0.46. The ‘unaccounted’ risk O:E is projected to increase to 4.72 while the projected observed O:E is 0.43 after two more PSR cycles. Having knowledge of the ‘at risk’ and identifying patients with ‘unaccounted’ risks for O:E helps LTx programs allocate resources in a more productive fashion to continue to achieve the level of expected outcomes and meet quality standards.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.2301177
DO  - 10.21926/obm.transplant.2301177
ID  - Afshar2023
ER  -