Faculty Collaboration Database

How Does Multiple Listing Affect Lung Transplantation? A Retrospective Analysis. Semin Thorac Cardiovasc Surg 2022;34(1):326-335

Date

05/11/2021

Pubmed ID

33971300

DOI

10.1053/j.semtcvs.2021.03.041

Scopus ID

2-s2.0-85107387402 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

The impact of multiple listing (ML) strategies on lung transplantation is unknown. Retrospective review of United Network for Organ Sharing (UNOS) registry for lung transplantation between May 1, 2005 and March 31, 2017 was performed. Characteristics of single (SL) and ML candidates were compared, and incidence density matching was used to select up to 10 controls for each case. Overall survival was evaluated using Cox regression stratified by matched sets. Nelson-Aalen estimators were used to estimate the cumulative incidence (CI) of transplant, death on the waiting list, and removal from wait-list as competing risks; Gray's test was used to compare wait list outcomes between groups. 23,445 subjects listed for lung transplant, of which 467 (2%) subjects listed at 2+ centers; 206 matched sets. There was no difference in overall survival of matched cases and controls at 1 year (ML 83.7%, SL 90.2%), 3 years (ML 63.9%, SL 68%), and 5 years (ML 51.9%, SL 49.3%) (p=0.24). The CIs of receiving a lung transplant at 2 years for ML and SL were 83.6% and 71%, respectively. Multi-listing increased the probability of receiving a transplant (p<0.001) but was not associated with waitlist mortality (p=0.13). There was no difference in post-transplant survival between ML and SL candidates (HR=0.82, p=0.32). ML was associated with a substantial increase in probability of lung transplantation, but there was no difference in overall survival, post-transplant, or wait-list mortality. Our study permits more informed decision-making for patients considering the ML strategy.

Author List

Zheng L, Chandratre S, Ali A, Szabo A, Durham L, Joyce LD, Joyce DL

Authors

Lucian A. Durham MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Humans
Lung Transplantation
Retrospective Studies
Tissue and Organ Procurement
Treatment Outcome
United States
Waiting Lists