Effects of case volume on short- and long-term outcomes following cadaveric lung transplantation in Japan

Masayuki Chida; Takashi Inoue; Takahiro Nakajima; Yoshinori Okada; Hisashi Oishi; Jun Nakajima; Masaaki Sato; Ichiro Yoshino; Hidemi Suzuki; Daisuke Nakajima; Yasushi Shintani; Takashi Kanou; Shinichi Toyooka; Kentaroh Miyoshi; Takeshi Shiraishi; Toshihiko Sato; Keitaro Matsumoto; Takeshi Nagayasu; Yasushi Hoshikawa; Yasushi Matsuda; Sumiko Maeda; Hiroshi Date

doi:10.21037/jtd-23-90

Effects of case volume on short- and long-term outcomes following cadaveric lung transplantation in Japan

J Thorac Dis. 2024 Feb 29;16(2):1473-1479. doi: 10.21037/jtd-23-90. Epub 2024 Feb 1.

Authors

Masayuki Chida¹, Takashi Inoue¹, Takahiro Nakajima¹, Yoshinori Okada², Hisashi Oishi², Jun Nakajima³, Masaaki Sato³, Ichiro Yoshino⁴, Hidemi Suzuki⁴, Daisuke Nakajima⁵, Yasushi Shintani⁶, Takashi Kanou⁶, Shinichi Toyooka⁷, Kentaroh Miyoshi⁷, Takeshi Shiraishi^{8

9}, Toshihiko Sato⁸, Keitaro Matsumoto¹⁰, Takeshi Nagayasu¹⁰, Yasushi Hoshikawa¹¹, Yasushi Matsuda¹¹, Sumiko Maeda¹, Hiroshi Date⁵

Affiliations

¹ Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Japan.
² Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
³ Department of Thoracic Surgery, The University of Tokyo, Tokyo, Japan.
⁴ Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
⁵ Department of Thoracic Surgery, Kyoto University Graduate School Medicine, Kyoto, Japan.
⁶ Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
⁷ Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
⁸ Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
⁹ Center of Organ Transplant Medicine, Fukuoka University Hospital, Fukuoka, Japan.
¹⁰ Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
¹¹ Department of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Japan.

Abstract

Background: Despite the low number of lung transplantations (LTs) in Japan, 10 LT facilities are accredited and good outcomes have been reported. A database review was conducted to clarify the impact of case volume at LT facilities in Japan on short- and long-term outcomes.

Methods: All cadaveric LT cases treated between 2000 and 2021 in Japan were analyzed using the database of the Japanese Society of Lung and Heart-Lung Transplantation (JSLHT). The nine institutions represented were categorized into the low-volume (LV; <80 cumulative LT cases, <8 LTs/year, n=5) and high-volume (HV; ≥80 cumulative LT cases, ≥8 LTs/year, n=4) centers. Ninety-day and 1-year mortality, as well as 5- and 10-year survival data were evaluated.

Results: A total of 658 cadaveric LTs were performed at the nine institutions. The 90-day rates of mortality at the HV and LV centers were 3.5% and 3.9%, respectively (P=0.801), while the 1-year mortality rates were 9.2% and 11.5%, respectively (P=0.199). Additionally, log-rank analysis of Kaplan-Meier curves showing case volume did not reveal a significant difference in long-term survival between the HV and LV centers (P=0.272), though the LV centers had wide differences for long-term outcomes (P=0.030).

Conclusions: Case volume did not have effects on short- or long-term outcomes following LT in Japan, while there were large variations in long-term outcomes among the LV centers compared to those of the HV centers.

Keywords: Lung transplantation (LT); case volume; long-term survival; mortality.