ABSTRACT
In May 2005, the lung allocation score (LAS) was implemented in the United States to allocate organs on the basis of medical urgency (and not strictly waiting time). Since then, waiting list times and mortality have improved, and sicker patients are receiving transplants with no effect on posttransplant survival. However, evidence that the locally based allocation system is impeding the full beneficial potential of the LAS is increasing. Geography continues to play a significant role in lung allocation in the United States, causing lungs to be regularly allocated to low-priority candidates while appropriately matched high-priority regional candidates are being bypassed.
