Lung Transplantation Survival Varies Among Centers

Variation in survival after transplant found to be only partly associated with procedure volume
By Eric Metcalf
HealthDay Reporter

TUESDAY, July 6 (HealthDay News) -- Survival following lung transplantation varies between transplantation centers, and the variation is only partially associated with volume of procedures, according to research published in the July 7 issue of the Journal of the American Medical Association.

Gabriel Thabut, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues analyzed data from the United Network for Organ Sharing registry on 15,642 adult patients who underwent lung transplantation from 1987 to 2009 in 61 U.S. transplantation centers.

The researchers found that survival rates among all the centers varied from 93.4 percent at one month to 49.5 percent at five years. After adjusting for the substantial variation in donors, recipients, and surgical techniques, hazard ratios for death ranged from 0.70 to 1.71 in the centers. Five-year survival rates ranged from 30 to 61.1 percent. Higher transplant volumes were associated with better long-term survival, and accounted for 15 percent of the variability among centers, but variability in performance was significant even after the researchers controlled for volume.

"Although the causes for variation were not all identified, annual procedural volume was found to be statistically significantly related to outcomes but accounted for only 15 percent of variability among center survival rates," write the authors of an accompanying editorial. "Perhaps the most important aspect of the analysis by Thabut et al is the provision of guidance for how to quantify the degree to which procedure volume contributes to outcomes."

A co-author has received support from AstraZeneca. An editorial co-author disclosed a past financial relationship with Allergan.

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