• Brandi B Scully, Matthew Goss, Hao Liu, Michael L Keuht, Iki Adachi, McKenzie E Dean ED Department of Surgery, Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, Texas, USA., Charles D Fraser, Ernestina Melicoff, George B Mallory, Jeffery S Heinle, and Abbas Rana.
• Department of Surgery, Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, Texas, USA.
• J. Heart Lung Transplant. 2017 Nov 1; 36 (11): 1201-1208.

BackgroundLow case volume has been associated with lower survival after pediatric lung transplantation. Our aim was to analyze waitlist outcomes among pediatric lung transplant centers in the USA.MethodsWe studied a cohort of 1,139 pediatric candidates listed in the Organ Procurement and Transplantation Network for lung transplantation between 2002 and 2014. Of these candidates, 720 (63.2%) received a transplant. Candidates were divided into groups according to the clinical activity of the center of listing: high-volume pediatric (≥4 transplants per year); low-volume pediatric (<4 transplants per year); and adult (transplant volume predominantly in adults). We used multivariate Cox regression analysis to identify independent risk factors for waitlist mortality. We also determined the transplant rate-or likelihood of transplant after listing-over the study period.ResultsFifty-eight percent of the children and adolescents were listed in adult centers where the resultant transplant rate was low-only 42% received a transplant compared with 93% in pediatric programs. Listing in an adult program was also the most significant risk factor for death on the waiting list (hazard ratio 15.6, 95% confidence interval 5.8 to 42.1).ConclusionsMost children (58%) are listed for lung transplantation in adult centers and have a reduced rate of transplantation and a greater chance of waitlist mortality.Copyright © 2017 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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