ArticleThe Journal of thoracic and cardiovascular surgery2022
Influence of broader geographic allograft sharing on outcomes and cost in smaller lung transplant centers.
Article in The Journal of thoracic and cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Activation of donor-derived eosinophils during static storage contributes to primary graft dysfunction after lung transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Impact of the Composite Allocation Score on Lung Transplant Waitlist and Posttransplant Outcomes.Transplantation direct · 2025Article
- Going the distance: Geographic effects of the lung transplant composite allocation score.JHLT open · 2024Article
- Readmissions and costs in cadaveric and living-donor lobar lung transplantation: Analysis using a national database.JHLT open · 2023Article
- Same-teams versus different-teams for long distance lung procurement: A cost analysis.The Journal of thoracic and cardiovascular surgery · 2023Article
- Commentary: From Locke to Merton to lung allocation: Unintended consequences.The Journal of thoracic and cardiovascular surgery · 2022Article
- Commentary: The 250-mile radius rule in lung transplant donation: Even the best intentions have untoward consequences.The Journal of thoracic and cardiovascular surgery · 2022Article
- Commentary: All politics are local. The impact of the new organ allocation system on a lung transplant center.The Journal of thoracic and cardiovascular surgery · 2022Article
- Commentary: The cost of drawing the line: Lung transplant programs in the post-donor service area era.The Journal of thoracic and cardiovascular surgery · 2022Article
- Commentary: Malpractice in heart transplantation.Journal of cardiac surgery · 2021Article
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8 authors.
Funding
Abstract
objectiveOn November 24, 2017, Organ Procurement and Transplantation Network implemented a change to lung allocation replacing donor service area with a 250 nautical mile radius around donor hospitals. We sought to evaluate the experience of a small to medium size center following implementation.
methodsPatients (47 pre and 54 post) undergoing lung transplantation were identified from institutional database from January 2016 to October 2019. Detailed chart review and analysis of institutional cost data was performed. Univariate analysis was performed to compare eras.
resultsSimilar short-term mortality and primary graft dysfunction were observed between groups. Decreased local donation (68% vs 6%; P < .001), increased travel distance (145 vs 235 miles; P = .004), travel cost ($8626 vs $14,482; P < .001), and total procurement cost ($60,852 vs $69,052; P = .001) were observed postimplementation. We also document an increase in waitlist mortality postimplementation (6.9 vs 31.6 per 100 patient-years; P < .001).
conclusionsFollowing implementation of the new allocation policy in a small to medium size center, several changes were in accordance with policy intention. However, concerning shifts emerged, including increased waitlist mortality and resource utilization. Continued close monitoring of transplant centers stratified by size and location are paramount to maintaining global availability of lung transplantation to all Americans regardless of geographic residence or socioeconomic status.
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