Selection Differences between Cardiac and Non-Cardiac Thoracic Surgeons in Lung Transplantation

Lung transplantations in North America are performed by cardiovascular (CV) and non-cardiovascular thoracic (TS) surgeons. In addition to differences in the type of surgeon performing the transplantation, there also exist well established differences in institutional volume. Anecdotal experience suggests that there are differences in selection of acceptable donors and recipients. We sought to elucidate surgical background and center volume influences on lung transplantation. We performed a web-based survey of CV and TS surgeons identified through their institutional affiliations at a North American training center. Surgeon practice type and center volume were compared. A total of 854 surveys were distributed with 45 (5.3%) responses received. The preferences of CV and TS surgeons were congruent in most respects, but CV and TS surgeons differed in selection of donors and recipients. CV surgeons accepted older recipients (Table 1, Figure 1, p=0.004) and tended towards accepting older donors. High volume centers transplanted older recipients (Table 2, p = 0.005), older donors (Table 2, p = 0.003) and patients with a longer cold ischemic time (Table 2, p=0.026) than low volume centers. It is imperative to gain insight into the factors that influence donor and recipient selection as to optimize organ allocation and usage.