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Program and OPO Specific Reports , January 2010

Report Published January 2010   
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University of California at Los Angeles Medical Center, Los Angeles, CA(LU)

Comments submitted by program:

Comments General Comments About This Program
University of California at Los Angeles Medical Center, Los Angeles, CA X

General Comments:

UCLA Lung and Heart-Lung Transplant Program The UCLA Lung & Heart-Lung Transplant Program has championed a philosophy of extending lung transplantation to “higher risk candidates”. The program routinely evaluates and transplants recipients with end-stage lung diseases as complicated by concurrent cardiac disease who may require simultaneous coronary arterial bypass grafting (CABG) or valve repair at the time of lung transplantation. The program’s criteria for candidacy have also been extended to “older age recipients” (>70 years) [Lung transplantation in older patients? J Thorac Cardiovasc Surg. 2008 Feb;135(2):412-20.] after development of a programmatic protocol for extensive screening and evaluation. Patients suffering from cardiopulmonary complications of a spectrum of collagen vascular diseases such as Scleroderma (PSS/CREST), Mixed Connective Tissue Disease (MCTD), Rheumatoid Arthritis (RA) and Polymyositis (PMS) have similarly all been successfully transplanted with superior clinical outcomes. Furthermore, the field has been advanced by novel methods for “organ reperfusion” which we have described with a decreased incidence of “primary graft dysfunction” (PGD). Hence, the program has successfully expanded our “donor criteria” in an effort to decrease the “waiting time” for transplantation in our Region. David Ross, MD Lung and Heart-Lung Transplant Program Medical Director
X

General Comments:

UCLA Lung and Heart-Lung Transplant Program The UCLA Lung & Heart-Lung Transplant Program has championed a philosophy of extending lung transplantation to “higher risk candidates”. The program routinely evaluates and transplants recipients with end-stage lung diseases as complicated by concurrent cardiac disease who may require simultaneous coronary arterial bypass grafting (CABG) or valve repair at the time of lung transplantation. The program’s criteria for candidacy have also been extended to “older age recipients” (>70 years) [Lung transplantation in older patients? J Thorac Cardiovasc Surg. 2008 Feb;135(2):412-20.] after development of a programmatic protocol for extensive screening and evaluation. Patients suffering from cardiopulmonary complications of a spectrum of collagen vascular diseases such as Scleroderma (PSS/CREST), Mixed Connective Tissue Disease (MCTD), Rheumatoid Arthritis (RA) and Polymyositis (PMS) have similarly all been successfully transplanted with superior clinical outcomes. Furthermore, the field has been advanced by novel methods for “organ reperfusion” which we have described with a decreased incidence of “primary graft dysfunction” (PGD). Hence, the program has successfully expanded our “donor criteria” in an effort to decrease the “waiting time” for transplantation in our Region. David Ross, MD Lung and Heart-Lung Transplant Program Medical Director

Program Summary
Center: University of California at Los Angeles Medical Center (CAUC)
Organ: LU: Lung
             
  Center Activity (07/01/2008-06/30/2009) Center Region United States   Tables for More Information
Deceased donor transplants (n=number) 42 209 1,554 07C,08C,09C
On waitlist at start (n) 66 202 2,090 01,02,03
On waitlist at end (n) 73 206 1,912 01,02
  Number of new patient registrations (n) 76 307 2,148   01,02
  Waiting List Outcomes ( 07/01/2008-06/30/2009)   Tables for More Information
    Observed Expected Statistical Significance of Difference    
Transplant rate (from deceased donors) among waitlist patients 0.59 0.91 Statistically Lower (b) 03,04,05,06
  Mortality rate while on waitlist 0.22 0.19 Not Significantly Different (a)   03,04
             
  Post-transplant Outcomes ( 07/01/2006-12/31/2008) 1 Year Tables for More Information
    Observed Expected Statistical Significance of Difference    
Adult/teen graft survival (based on 144  transplants) (%) 88.59 81.81 Statistically Higher (b) 10
Adult/teen patient survival (based on 139  transplants) (%) 89.65 83.20 Statistically Higher (b) 11
  Pediatric (<12) graft survival (%) NA NA NA   10
Pediatric (<12) patient survival (%) NA NA NA 11
The data reported here were prepared by the Scientific Registry of Transplant Recipients (SRTR) under contract with the Health Resources and Services Administration (HRSA).
Note:  Tables referring to small sample sizes should be treated with caution.  Sample sizes can be found in the table referenced in the last column.
NA=Not Applicable. 
The SRTR is administered by the Arbor Research Collaborative for Health with the University of Michigan,
with oversight and funding from the Health Resources and Services Administration.

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