A comparison of outcomes after lung transplantation between European and North American centers
Section snippets
Methods
Since a majority of LT are performed in North America (NA) or Europe,4 we performed a retrospective, comparative cohort analysis of adult patients undergoing deceased donor single or double LT in these 2 regions between January 2006 and December 2016. Data up to April 2019 were abstracted from the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Organ Registry. Exclusion criteria included re-transplantation, multiorgan transplantation, prior transplantation of any type,
Results
Overall, 21,777 patients (18,136 NA vs 3,641 Europe) were included in this study. At baseline, European recipients were more likely to be younger than 65 years, more frequently suffered from obstructive lung disease, and had longer ischemic times compared to NA recipients. European lung donors were more than a decade older than the NA cohort. Donor and recipient baseline characteristics are presented in Table 1.
Propensity-score matching resulted in 3,115 well-matched pairs (Table 1). One
Discussion
In the current study, we found significantly better OS after lung transplantation in European patients compared to a contemporaneous, propensity-matched cohort of North American patients. Others have noted similar findings in kidney transplantation.1,2 Furthermore, our sensitivity analysis, which excluded Canadian patients by using the UNOS data, demonstrated an accentuated difference in survival between US and European patients.
A number of donor and recipient related factors can influence
Acknowledgments
This study is funded by National Heart, Lung and Blood Institute R01HL146856-02 (Varun Puri).
Disclosures
None.
References (24)
- et al.
Predictors of lung transplant survival in eurotransplant
Am J Transplant
(2003) - et al.
A multicenter case series documenting Medicare Part D plan denials of immunosuppressant drug coverage for organ transplant recipients
Am J Transplant
(2021) - et al.
Report from the 2018 consensus conference on immunomodulating agents in thoracic transplantation: access, formulations, generics, therapeutic drug monitoring, and special populations
J Heart Lung Transplant
(2020) - et al.
National healthcare delivery systems influence lung transplant outcomes for cystic fibrosis
Am J Transplant
(2015) - et al.
Starting a lung transplant program: a roadmap for long-term excellence
Chest
(2015) - et al.
The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-fifth adult heart transplantation report-2018; focus theme: multiorgan transplantation
J Heart Lung Transplant
(2018) - et al.
Comparison of the long-term outcomes of kidney transplantation: USA versus Spain
Nephrol Dial Transplant
(2013) - et al.
Do outcomes after kidney transplantation differ for black patients in England versus New York State? A comparative, population-cohort analysis
BMJ Open
(2017) - The International Society For Heart and Lung Transplantation. Standards and guidelines....
- et al.
Developments in lung transplantation over the past decade
Eur Respir Rev
(2020)
Graft ischemic time and outcome of lung transplantation: a multicenter analysis
Am J Respir Crit Care Med
Lung allocation score: the Eurotransplant model versus the revised US model - a cross-sectional study
Transpl Int
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These authors contributed equally to the manuscript.