Association of Heart Transplant Volume with Presence of Lung Transplant Programs and Heart Transplant’s SRTR One-year Survival Rating

Abstract

Background Several factors affect heart transplant (HTx) and lung transplant (LTx) program outcomes. Variabilities in institutional and community characteristics have been shown to influence survival. At present, half of HTx centers in the United States do not possess a concomitant LTx program. This study sought to better understand the characteristics of HTx with and without LTx programs.

Methods Nationwide transplant data were collected from the Scientific Registry of Transplant Recipients (SRTR) in August 2020. SRTR star rating ranges from tier 1 (lowest) to tier 5 (highest). HTx volumes and SRTR star ratings for survival were compared between the centers with heart-only (H0) programs and the centers with heart-lung (HL) programs.

Results SRTR star ratings were available for 117 transplant centers with one or more HTx reported. The median number of HTx performed over 1 year was 16 (interquartile range [IQR]: 2–29). The number of HL centers (n = 67, 57.3%) were comparable to H0 centers (n = 50, 42.7%; p = 0.14). The HTx volume at the HL centers (28 [IQR: 17–41]) exceeded the HTx volume at the H0 centers (13 [IQR: 9–23]; p < 0.01), but were comparable to the LTx volume at the HL centers (31 [IQR: 16–46]; p = 0.25). The median HTx one-year survival rating was 3 (IQR: 2–4) at both the H0 and HL centers (p = 0.85). The HTx and LTx volumes were positively associated with the respective 1-year survivals (p < 0.01).

Conclusion While the presence of an LTx program is not directly associated with HTx survival, it has a positive association with the HTx volume. The HTx and LTx volumes are positively associated with the 1-year survival.

Keywords

cardiac transplantation - heart transplantation - lung transplantation - survival - outcomes

Authors' Contribution

JLR was responsible for the concept/design, data collection, data verification and quality assurance, data interpretation, data analysis, and drafting of the article. DA was responsible for concept/design, data collection, data verification and quality assurance, data analysis, supervision of data analysis, drafting of the article, critical revision of the article, and interpretation. AU performed data collection, data verification and quality assurance, concept/design, data interpretation, and statistics. AB was responsible for drafting the article, data verification and quality assurance, critical revision of the article, data interpretation, and concept/design. GG was responsible for data collection, concept/design, data analysis, and data interpretation. IR, JER, RJA, KR, JWE, and HTM were responsible for concept/design, critical revision of the article, drafting of the article, and data interpretation. VT was responsible for concept/design, data verification and quality assurance, supervision of data analysis, drafting of the article, critical revision of the article, and approval of the article as the principal investigator.

Publikationsverlauf

Eingereicht: 06. Januar 2023

Angenommen: 15. Mai 2023

Accepted Manuscript online:
17. Mai 2023

Artikel online veröffentlicht:
15. Juli 2023

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