Survival in pediatric lung transplantation: The effect of center volume and expertise

Transplant center volume and outcomes in lung transplantation for cystic fibrosis

“…Lung transplantation (LTx) is a surgical treatment option for end‐stage lung disease, including cystic fibrosis (CF) . Center volume of LTx has been used as a measure of center expertise, and has been shown to predict improved survival after this procedure . High‐volume centers are considered to attain better outcomes of LTx due to greater resource availability, more experience with complex care including extracorporeal membrane oxygenation (ECMO), and advanced understanding of transplant‐related complications and therapeutic interventions .…”

Pediatric lung transplantation and end of life care in cystic fibrosis: Barriers and successful strategies

“…Reported pediatric lung transplants per year now ranges from roughly 100-137 per year worldwide. The majority of pediatric lung transplants are performed in [11][12][13][14][15][16][17] year-olds and CF is the most common indication for transplant. There has been a modest improvement in median survival when comparing cohorts before and after the year 2000 (3.3 vs 5.8 years, P = 0.0007), but certainly survival lags behind most other solid organ transplants.…”

“…Center volume and center type both have an impact on survival. While children transplanted at larger volume pediatric centers have improved survival compared to those transplanted at smaller volume centers, this survival advantage did not carry over to children transplanted at large volume adult centers, suggesting that pediatric expertise also plays an important role in survival . CF‐specific experience is also important: Hayes et al found that CF lung transplant volume was a stronger predictor of overall survival than overall transplant volume alone.…”

“…17 year-old recipients (8.2 vs 4.8 years, P < 0.5). Recipients under 6 years of age demonstrate a non-statistical increase in median survival when compared to[11][12][13][14][15][16][17] year-olds. Bronchiolitis obliterans and graft failure continue to be the major causes of death in all age groups 10.…”

Lung Transplantation in Cystic Fibrosis: Trends and Controversies

“…Centers with higher volumes of pediatric lung transplants are noted to have better patient survival statistics than low-volume centers, and pediatric experience additionally contributes to improved lung transplant outcomes in children. 38 More pediatric-specific research on topics such as extending pretransplant survival and designing directed treatments for AMR and CLAD is needed. Given that few pediatric patients will require lung transplant, multicenter trials and collaboration with adult centers will be used to fill our knowledge gaps.…”