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
Journal of thoracic disease 16(2) 1473-1479 2024年2月29日
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.