TUESDAY, July 6 (HealthDay News) -- Five-year survival rates for
U.S. lung transplant patients vary widely depending on where they
had their operation, a new study finds.
About 1,500 lung transplantations are performed each year at the
61 lung transplantation centers across country, researchers Dr.
Gabriel Thabut, of the Mayo Clinic College of Medicine in
Rochester, Minn., and colleagues, said in a news release.
In this study, Thabut's team analyzed data from the United
Network for Organ Sharing registry on almost 16,000 patients who
underwent lung transplantation between 1987 and 2009. Overall, the
median (midpoint) survival for patients was 4.9 years. The
one-month survival rate was 93.4 percent, and one-, three-, and
five-year survival rates were 79.7 percent, 63 percent, and 49.5
"Characteristics of donors, recipients, and surgical techniques varied substantially among centers," the researchers said.
After adjusting for these factors, the team found that the risk
of death ranged from 30 percent lower at low-risk centers to 70
percent higher at high-risk centers. Five-year survival rates
ranged from 30 percent to more than 61 percent.
The study appears in the July 7 issue of the
Journal of the American Medical Association.
"The center where a patient undergoes [lung transplant] may be a major determinant of survival rate," the researchers conclude. "The observation that this variability among centers remains after controlling for differences in the selection of donors, recipients, or surgical approaches suggests that centers may exhibit true differences in the quality of care provided during or following transplantation," they add.
Lower-performing centers can learn from those that do better,
the team believes. "There is a great need to explore practices at
high-performing centers with the goal of exporting beneficial
practices to lower-performing centers. If such efforts do not
equalize outcomes for lung transplant recipients, consideration
might be given to further regionalizing the [lung transplant]
system in the United States," they concluded.
Reports on volume-outcome relationships, however, often have
flawed methodology, cautioned Dr. Edward Livingston, of the
University of Texas Southwestern Medical Center, Dallas, and Jing
Cao of Southern Methodist University in Dallas, in an accompanying
editorial. In particular, they wrote, "little attention has been
given to the quality of statistical analysis used to support
claims" that better outcomes occur at high-volume centers.
There's more on lung transplant at the
U.S. National Heart, Lung, and Blood