Purpose: We examined if the geographic distance recipients travel for lung transplant care impacts posttransplant survival at our center.

Methods: Retrospective single center cohort study of all adult (≥18 years), first time lung only transplants from January 1, 2010 until December 31, 2015. Recipient distance to transplant center was calculated using a straight line from the recipient home zip code to our transplant center and divided into 4 categories: ≤50 miles, >50 to ≤250 miles, >250 to ≤500 miles, and >500 miles. We excluded patients hospitalized at the time of transplant. The primary outcome was posttransplant graft survival, defined as time until patient death or re-transplant.

Results: 375 recipients met inclusion criteria. There were no significant differences among the 4 recipient to transplant center distance categories by gender, median age, single vs. double transplant, or Lung Allocation Score at the time of transplant. Posttransplant graft survival was 90%, 86%, 90%, and 74% at one year and 59%, 55%, 78%, and 50% at three years posttransplant for travel distances of ≤50, >50 and ≤250, >250 and ≤500, and >500 miles, respectively (p = 0.10). In a multivariable cox model, distance to transplant center was not associated with posttransplant graft survival. Conclusion: One and three year posttransplant graft survival was not associated with the distance a recipient traveled from home to our center. Potential changes in donor lung allocation policies towards broader geographic sharing may direct lungs to high volume transplant centers and away from low volume centers. As a result, patients may need to travel further to reach a high volume lung transplant center. Our findings suggest that posttransplant survival is unlikely to be impacted by such allocation strategies. Further work is needed to: (1) identify other clinical variables which may explain our findings, (2) replicate our methods in a larger multicenter cohort, and (3) understand patient level costs and preferences in traveling for lung transplant care.

CITATION INFORMATION: Tsuang W, Lin S, Schold J, Valapour M. Lung Transplant Recipient Travel Distance to Transplant Center Does Not Impact Survival. Am J Transplant. 2017;17 (suppl 3).

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