Figures
- FIGURE 1
Comparison of the characteristics at first enrolment for United Network for Organ Sharing (UNOS) patients (n=8315) and virtual patients (n=2 048 784). a) Age; b) body mass index (BMI); c) oxygen at rest; d) serum creatinine; e) pulmonary artery pressure (PAP); f) pulmonary capillary wedge pressure (PCWP); g) forced vital capacity (FVC); h) lung allocation score (LAS); i) New York Heart Association (NYHA) class; j) 6-min walk distance <150 feet (∼46 m); k) continuous mechanical ventilation (CMV); l) diabetes.
- FIGURE 2
a) Pre- and post-lung transplantation (LT) survival time according to diagnosis group. b) Overall outcome from the waiting list (WL) according to the scenario of organ scarcity. c) Time spent on the WL for each outcome according to the scenario of organ scarcity. R80: 80 organs for 100 virtual patients; R96: 96 organs for 100 virtual patients.
- FIGURE 3
a) Evolution of the yearly mortality rate from year 1 to year 15 of simulation according to the operating rule and to the scenario of organ scarcity. b) Evolution of the median time spent on the waiting list (WL) before undergoing lung transplantation from year 1 to year 15 of simulation. Evolution of the size of the WL under c) the high emergency allocation rule or d) the “first-in, first-out” (FIFO) rule at the end of years 1 to 15 of simulation according to different scenarios of organ scarcity (from 60 to 105 organs for 100 virtual patients (VPs); including scenarios R80 and R96). HELTx: high emergency lung transplantation system; R80: 80 organs for 100 VPs; R96: 96 organs for 100 VPs.
- FIGURE 4
a) Evolution of the proportion of virtual patients (VPs) that died or received a graft while on the high-priority list by year according to the scenario of organ scarcity. b) Evolution of the median lung allocation (LAS) at the time of transplantation according to the operating rule, the scenario of organ scarcity and the high-priority status. c) Evolution of the median post-transplantation survival according to the operating rule and the scenario of organ scarcity. R80: 80 organs for 100 VPs; R96: 96 organs for 100 VPs; FIFO: “first in, first out” HELTx: high emergency lung transplantation system.
- FIGURE 5
Overall survival from enrolment according to operating rule and scenario of organ scarcity for a) scenario R96 (i.e. 96 organs for 100 virtual patients (VPs)) and b) scenario R80 (i.e. 80 organs for 100 VPs). Survival at years c) 1, d) 5 and e) 10 after enrolment under scenario R80 according to diagnosis group and operating rule. FIFO: “first-in, first-out”; HELTx: high emergency lung transplantation system.
Tables
- TABLE 1
Outcome of virtual patients across simulations according to the operating rule and organ/receiver ratio
Received a transplant Died on the waiting list Proportion Time since first enrolment months Proportion Time since first enrolment months For an organ/receiver ratio of 0.96 Under the FIFO strategy 95.1% (92.0–97.8%) 1.2 (0–2.8) 3.9% (1.9–7.0%) 0.9 (0.5–1.6) Under the HELTx strategy 95.2% (92.5–97.9%) 2.1 (0.2–3.9) 3.2% (1.6–4.6%) 1.3 (0.2–2.3) Among which patients in high priority# 69.7% (60.9–74.7%) 1.6 (0.9–2.5) 30.1% (25.3–38.9%) 0.7 (0–1.8) For an organ/receiver ratio of 0.80 Under the FIFO strategy 77.9% (75.7–80.2%) 7.4 (6.2–8.3) 18.4% (16.3–20.4%) 3.7 (3.2–4.2) Under the HELTx strategy 77.9% (75.2–80.3%) 11.9 (9.7–14.1) 14.8% (12.6–17.2%) 6.2 (5.3–7.2) Among which patients in high priority¶ 69.5% (67.5–71.3%) 5.4 (4.6–6.0) 30.3% (28.6–32.3%) 5.8 (4.4–6.5) Data are presented as median (90% central range). FIFO: “first-in, first-out” rule; HELTx: high emergency LT system. #: 6.0% of HELTx, 90% central range 3.1–8.9%; ¶: 25.0% of HELTx, 90% central range 22.1–28.3%.
Supplementary Material
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Supplementary material 00020-2017_supp
Supplementary Material
J.D. Christie 00020-2017_Christie
