Poor Outcomes on the Waiting List for Pediatric Lung Retransplant Patients Listed in Low Volume Centers.
1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX
2Department of Pediatrics and Pulmonology, Baylor College of Medicine, Houston, TX
Meeting: 2017 American Transplant Congress
Abstract number: 157
Keywords: Lung transplantation, Pediatric, Waiting lists
Session Information
Session Name: Concurrent Session: Lung Transplantation from Donation to Retransplantation
Session Type: Concurrent Session
Date: Sunday, April 30, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 5:30pm-5:42pm
Location: E270
Purpose
Low case volume has been associated with lower survival after pediatric lung transplantation. In addition, pediatric lung retransplantation has been associated with low overall survival rates compared with primary lung transplantation. Our aim was to analyze waitlist outcomes for retransplant patients among pediatric lung transplant centers in the USA.
Methods
We studied a cohort of 1,139 candidates listed in the Organ Procurement and Transplantation Network for pediatric lung transplantation between 2002 and 2014; of these, 80 patients (7.0%) were retransplants. Candidates were divided into groups according to the average volume of yearly pediatric transplants performed in the listing center over twelve years: >10, 6-10, 3-5, and <3. Contingency table analysis was used to compare proportions between groups.
Results
46% (37/80) of the pediatric lung retransplant candidates were listed in low-pediatric volume centers, those in which fewer than 3 pediatric transplants were performed annually. These listed candidates had limited access to transplantation; only 32% (12/37) received a second transplant versus 93% (26/28) in high-volume centers (>10 annual transplants, (p<0.0001)).
Patients listed at a low-pediatric volume center (< 3 annual transplants) had a higher waitlist mortality rate (51%) when compared with patients listed at a center that performed 3 to 5 transplants per year (20% mortality (p=0.08)), 6 to 10 transplants per year (0% mortality (p=0.03)), or >10 transplants per year (3.6% mortality (p<0.0001)). There was no difference in post-transplant survival over the study time period between patients transplanted at low pediatric volume centers when compared with the other groups.
Conclusions
46% of pediatric lung retransplant candidates are listed in low pediatric volume transplant centers. These children have limited access to transplantation and a higher mortality rate on the waitlist.
CITATION INFORMATION: Scully B, Heinle J, Kueht M, McKenzie E, Mallory G, Melicoff E, Rana A. Poor Outcomes on the Waiting List for Pediatric Lung Retransplant Patients Listed in Low Volume Centers. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Scully B, Heinle J, Kueht M, McKenzie E, Mallory G, Melicoff E, Rana A. Poor Outcomes on the Waiting List for Pediatric Lung Retransplant Patients Listed in Low Volume Centers. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/poor-outcomes-on-the-waiting-list-for-pediatric-lung-retransplant-patients-listed-in-low-volume-centers/. Accessed May 17, 2025.« Back to 2017 American Transplant Congress