At 1,500 Lung Transplants, the Penn Transplant Institute Achieves A Milestone in Research and Experience

On June 2, 2022, the Penn Transplant Institute completed its 1,500th lung transplant, roughly 30 years after its first procedure in November 1991.

"We celebrate this achievement because it signifies the contributions of an incredible team and the trust that so many have placed in our hands," said Lung Transplant Program Surgical Director Christian A. Bermudez, MD, adding that Penn is one of only seven adult lung transplant programs in the United States to reach this milestone.

Is Lung Transplant Volume an Important Measure for Outcomes?

Volume — the number of individuals receiving a specific procedure at a single institution — has long been considered to have an association with positive outcomes (i.e., graft and patient survival) in transplant surgery.

In a reference to heart transplantation, for example, a 2019 OPTIN/UNOS ethics committee report declared "It is well documented that the outcomes of many surgical procedures in general, and some organ transplantations specifically, are tied to the volume of the procedures at a given center, with volume acting as a surrogate for experience. Greater experience is associated with better outcomes." [1]

Although the question of center volume has yet to be clearly defined in lung transplantation, an increasing number of studies over the last decade suggest that center volume is an indicator of proficiency and positive outcomes in lung transplantation.[2-4]

Lung Transplantation in UNOS Region 2

The definitive treatment for refractory end-stage lung disease, lung transplantation has seen a steady increase in numbers in Pennsylvania in recent years by comparison to its partner states in UNOS Region 2, which extends in latitude from Pennsylvania to Virginia and longitudinally from New Jersey to West Virginia.

In Pennsylvania, only three centers offer lung transplantation: Temple University Hospital, the University of Pittsburgh Medical Center (UPMC) and the Penn Transplant Institute at the Hospital of the University of Pennsylvania (HUP). According to the latest report of the Scientific Registry of Transplant Recipients (SRTR), the Penn Transplant Institute leads the region in waiting list transplants within 30 days and one year, as well as reduction in pre-transplant mortality for lung transplantation. [5] In addition, only Penn Medicine is supported by a US News & World Report top 10 ranked program for pulmonology and lung surgery.

References:

1. OPTN Ethics Committee. Ethical implications of Multi-Organ Transplant. Available at: https://optn.transplant.hrsa.gov/media/2989/ethics_boardreport_201906.pdf.
2. Jawitz OK, Raman V, Bryner, BA, et al. Transplant Int 2021;34:194-203.
3. Ranganath NK, Malas J, Chen S, et al. Ann Thorac Surg 2021;111:1652-1658.
4. Hayes D, Hartwig MG, Tobias JD, et al. Am J Transplant. 2017;17: 218 – 226.
5. Scientific Registry of Transplant Recipients. Accessed 18 July 2022. Available at: https://www.srtr.org/transplant-centers/?&organ=lung&recipient Type=adult&state =PA&sort=rating.