Jeremiah A Hayanga1, Alena Lira2, Tedi Vlahu3, Jonathan D'Cunha4, Heather K Hayanga5, Reda Girgis3, Jonathan Aboagye6, Asghar Khaghani3. 1. Department of Cardiothoracic Surgery, DeVos Heart & Lung Transplantation Program, Spectrum Health-Michigan State University, 330 Barclay Avenue NE, Suite 200, Grand Rapids, MI 49503, USA. Electronic address: jhayanga@me.com. 2. Department of Pulmonary-Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA. 3. Department of Cardiothoracic Surgery, DeVos Heart & Lung Transplantation Program, Spectrum Health-Michigan State University, 330 Barclay Avenue NE, Suite 200, Grand Rapids, MI 49503, USA. 4. Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 5. Department of Anesthesia, Johns Hopkins School of Medicine, Baltimore, MD, USA. 6. Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
Abstract
BACKGROUND: We sought to evaluate the effect of center volume on patient survival. METHODS: We performed a retrospective analysis on nationwide data from the Scientific Registry of Transplant Recipients provided by United Network for Organ Sharing pertaining to lung transplantation (LT) recipients transplanted between 2005 and 2013. Centers were categorized into 4 groups based on their annual volume as follows: less than 20, 20 to 29, 30 to 39, and greater than or equal to 40 LTs. Baseline characteristics were compared and Kaplan-Meier analysis was used to estimate survival. RESULTS: A total of 13,506 adult recipients underwent LT during the study period. Of these, 2,491 (18.4%) patients were transplanted in centers with volume less than 20, 2,562 (19.0%) in centers with volume 20 to 29, 2,998 (22.2%) in centers with volume 30 to 39, and 5,455(40.4%) in centers with volume greater than or equal to 40. Survival was poorest in the lowest volume centers (1-year 81.4% vs 85.5% and 5-year 49.7% vs 56.5%, respectively). CONCLUSIONS: Post-LT survival in low volume centers is significantly lower than in high volume centers but the explanatory power of volume as a predictor of survival is low.
BACKGROUND: We sought to evaluate the effect of center volume on patient survival. METHODS: We performed a retrospective analysis on nationwide data from the Scientific Registry of Transplant Recipients provided by United Network for Organ Sharing pertaining to lung transplantation (LT) recipients transplanted between 2005 and 2013. Centers were categorized into 4 groups based on their annual volume as follows: less than 20, 20 to 29, 30 to 39, and greater than or equal to 40 LTs. Baseline characteristics were compared and Kaplan-Meier analysis was used to estimate survival. RESULTS: A total of 13,506 adult recipients underwent LT during the study period. Of these, 2,491 (18.4%) patients were transplanted in centers with volume less than 20, 2,562 (19.0%) in centers with volume 20 to 29, 2,998 (22.2%) in centers with volume 30 to 39, and 5,455(40.4%) in centers with volume greater than or equal to 40. Survival was poorest in the lowest volume centers (1-year 81.4% vs 85.5% and 5-year 49.7% vs 56.5%, respectively). CONCLUSIONS: Post-LT survival in low volume centers is significantly lower than in high volume centers but the explanatory power of volume as a predictor of survival is low.