Urgent lung allocation system in the Scandiatransplant countries

Research output: Contribution to journalArticle


BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year. This study aims to explore the characteristics and outcome of patients listed as urgent, assess changes associated with the implementation of ScULAS, and describe how the system was utilized by the member centers. METHODS: All patients listed for lung transplantation at the 5 Scandiatransplant centers 5 years before and after implementation of ScULAS were included. RESULTS: After implementation, 8.3% of all listed patients received urgent status, of whom 81% were transplanted within 4 weeks. Patients listed as urgent were younger, more commonly had suppurative lung disease, and were more often on life support compared with patients without urgent status. For patients listed as urgent, post-transplant graft survival was inferior at 30 and 90 days. Although there were no pre-defined criteria for urgent listing, the system was not utilized at its maximum. CONCLUSIONS: ScULAS rapidly allocated organs to patients considered urgent. These patients were younger and more often had suppurative lung disease. Patients with urgent status had inferior short-term outcome, plausibly due to the higher proportion on life support before transplantation.


  • Henrik Auråen
  • Hans Henrik L. Schultz
  • Pekka Hämmäinen
  • Gerdt C. Riise
  • Hillevi Larsson
  • Lennart Hansson
  • Göran Dellgren
  • Michael Perch
  • Odd Geiran
  • Arnt E. Fiane
  • Martin Iversen
  • Are Martin Holm
External organisations
  • Oslo university hospital
  • University of Oslo
  • Copenhagen University Hospital
  • Helsinki University Central Hospital
  • Sahlgrenska University Hospital
  • Norwegian Radium Hospital
  • University of Copenhagen
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery


  • allocation, lung, scandiatransplant, transplantation, urgency
Original languageEnglish
Pages (from-to)1403-1409
JournalJournal of Heart and Lung Transplantation
Issue number12
Early online date2018
Publication statusPublished - 2018 Dec
Publication categoryResearch