Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
Christiana Care Health System, Wilmington, Delaware, United States.
Thorac Cardiovasc Surg. 2024 Jun;72(4):261-265. doi: 10.1055/a-2095-6636. Epub 2023 May 17.
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.
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.
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 ( = 67, 57.3%) were comparable to H0 centers ( = 50, 42.7%; = 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]; < 0.01), but were comparable to the LTx volume at the HL centers (31 [IQR: 16-46]; = 0.25). The median HTx one-year survival rating was 3 (IQR: 2-4) at both the H0 and HL centers ( = 0.85). The HTx and LTx volumes were positively associated with the respective 1-year survivals ( < 0.01).
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.
有几个因素会影响心脏移植（HTx）和肺移植（LTx）项目的结果。机构和社区特征的变异性已被证明会影响生存率。目前，美国有一半的 HTx 中心没有同时开展 LTx 项目。本研究旨在更好地了解有和没有 LTx 项目的 HTx 的特点。
2020 年 8 月，从移植受者科学注册处（SRTR）收集了全国范围内的移植数据。SRTR 星级评分范围从 1 级（最低）到 5 级（最高）。在只有心脏（H0）项目的中心和有心脏-肺（HL）项目的中心之间，比较了 HTx 中心的 HTx 量和 SRTR 生存率星级评分。
有 117 个移植中心报告了一个或多个 HTx，可获得 SRTR 星级评分。1 年内进行的 HTx 中位数为 16 例（四分位距[IQR]：2-29）。HL 中心的数量（ = 67，57.3%）与 H0 中心（ = 50，42.7%； = 0.14）相当。HL 中心的 HTx 量（28 [IQR：17-41]）超过 H0 中心的 HTx 量（13 [IQR：9-23]； < 0.01），但与 HL 中心的 LTx 量相当（31 [IQR：16-46]； = 0.25）。H0 和 HL 中心的 HTx 术后 1 年生存率中位数均为 3（IQR：2-4）（ = 0.85）。HTx 和 LTx 量与各自的 1 年生存率呈正相关（ < 0.01）。
虽然 LTx 项目的存在与 HTx 生存率没有直接关系，但它与 HTx 量呈正相关。HTx 和 LTx 量与 1 年生存率呈正相关。
