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Textbook surgical outcome in lung transplantation: Analysis of a US national registry.

Publication ,  Journal Article
Krischak, MK; Au, S; Halpern, SE; Olaso, DG; Moris, D; Snyder, LD; Barbas, AS; Haney, JC; Klapper, JA; Hartwig, MG
Published in: Clin Transplant
April 2022

INTRO: Textbook surgical outcome (TO) is a novel composite quality measure in lung transplantation (LTx). Compared to 1-year survival metrics, TO may better differentiate center performance, and motivate improvements in care. To understand the feasibility of implementing this metric, we defined TO in LTx using US national data, and evaluated its ability to predict post-transplant outcomes and differentiate center performance. METHODS: Adult patients who underwent isolated LTx between 2016 and 2019 were included. TO was defined as freedom from post-transplant length of stay > 30 days, 90-day mortality, intubation or extracorporeal membrane oxygenation at 72 h post-transplant, post-transplant ventilator support lasting ≥5 days, postoperative airway dehiscence, inpatient dialysis, pre-discharge acute rejection, and grade 3 primary graft dysfunction at 72 h. Recipient and donor characteristics and post-transplant outcomes were compared between patients who achieved and failed TO. RESULTS: Of 8959 lung transplant recipients, 4664 (52.1%) achieved TO. Patient and graft survival were improved among patients who achieved TO (both log-rank P < .0001). Among 62 centers, adjusted rates of TO ranged from 27.0% to 72.4% reflecting a wide variability in center-level performance. CONCLUSION: TO defined using national data may represent a novel composite metric to guide quality improvement in LTx across US transplant centers. SUMMARY: In this study we defined textbook outcome (TO) for lung transplantation (LTx) using US national data. We found that achievement of TO was associated with improved post-transplant survival, and wide variability in center-level LTx performance. These findings suggest that TO could be readily implemented to compare quality of care among US LTx centers.

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Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

April 2022

Volume

36

Issue

4

Start / End Page

e14588

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Lung Transplantation
  • Humans
  • Graft Survival
  • Adult
  • 3202 Clinical sciences
 

Citation

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Krischak, M. K., Au, S., Halpern, S. E., Olaso, D. G., Moris, D., Snyder, L. D., … Hartwig, M. G. (2022). Textbook surgical outcome in lung transplantation: Analysis of a US national registry. Clin Transplant, 36(4), e14588. https://doi.org/10.1111/ctr.14588
Krischak, Madison K., Sandra Au, Samantha E. Halpern, Danae G. Olaso, Dimitrios Moris, Laurie D. Snyder, Andrew S. Barbas, John C. Haney, Jacob A. Klapper, and Matthew G. Hartwig. “Textbook surgical outcome in lung transplantation: Analysis of a US national registry.Clin Transplant 36, no. 4 (April 2022): e14588. https://doi.org/10.1111/ctr.14588.
Krischak MK, Au S, Halpern SE, Olaso DG, Moris D, Snyder LD, et al. Textbook surgical outcome in lung transplantation: Analysis of a US national registry. Clin Transplant. 2022 Apr;36(4):e14588.
Krischak, Madison K., et al. “Textbook surgical outcome in lung transplantation: Analysis of a US national registry.Clin Transplant, vol. 36, no. 4, Apr. 2022, p. e14588. Pubmed, doi:10.1111/ctr.14588.
Krischak MK, Au S, Halpern SE, Olaso DG, Moris D, Snyder LD, Barbas AS, Haney JC, Klapper JA, Hartwig MG. Textbook surgical outcome in lung transplantation: Analysis of a US national registry. Clin Transplant. 2022 Apr;36(4):e14588.
Journal cover image

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

April 2022

Volume

36

Issue

4

Start / End Page

e14588

Location

Denmark

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Lung Transplantation
  • Humans
  • Graft Survival
  • Adult
  • 3202 Clinical sciences