Most countries now use a Lung Allocation Score (LAS) to determine priority on the waitlist. The LAS score is based on risk prediction models and balances waitlist and transplant outcomes, rather than accumulated waitlist time. There are some differences between the the UNOS LAS score and the European LAS but the principles remain the same. Sufficient statistical data for children is lacking so many countries apply the LAS to teenagers and adults, while some (e.g. Italy) only use it for adults. Implementation of LAS has generally reduced waitlist time and mortality and increased transplantation rates, without affecting transplant survival.
The Eurotransplant calculator uses basic demographic data (age, height, weight, lung diagnosis), degree of physical limitation (assistance level, 6MWT), respiratory support (oxygen requirements, ventilation, ECMO), lung function (predicted FVC, pCO2 level), pulmonary artery pressures, organ function (diabetes, creatinine) to calculate the LAS. This has to be updated on a regular basis.
AM Holm, F Immer & C Benden. Lung allocation for transplant: The European perspective. Clinical Transplantation. 2020;34:e13883
Last Updated: April 2023