Starting a lung transplant program: a roadmap for long-term excellence.
Lung transplantation is an effective therapy for many patients with end-stage lung disease. Few centers across the United States offer this therapy, as a successful lung transplant program requires significant institutional resources and specialized personnel. Analysis of the United Network of Organ Sharing database reveals that the failure rate of new programs exceeds 40%. These data suggest that an accurate assessment of program viability as well as a strategy to continuously assess defined quality measures is needed. As part of strategic planning, regional availability of recipient and donors should be assessed. Additionally, analysis of institutional expertise at the physician, support staff, financial, and administrative levels is necessary. In May of 2007, we started a new lung transplant program at the University of Iowa Hospitals and Clinics and have performed 101 transplants with an average recipient 1-year survival of 91%, placing our program among the top in the country for the past 5 years. Herein, we review internal and external factors that impact the viability of a new lung transplant program. We discuss the use of four prospectively identified quality measures: volume, recipient outcomes, financial solvency, and academic contribution as one approach to achieve programmatic excellence.
Department of Internal Medicine, University of Iowa Carver College of Medicine. Electronic address: julia-klesney-tait@uiowa.edu.
Julia
J
Klesney-Tait
Department of Internal Medicine, University of Iowa Carver College of Medicine.
Michael
M
Eberlein
Department of Internal Medicine, University of Iowa Carver College of Medicine; Veterans Affairs Medical Center, Iowa City, IA.
Lois
L
Geist
Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine; Veterans Affairs Medical Center, Iowa City, IA.
John
J
Keech
Department of Internal Medicine, University of Iowa Carver College of Medicine.
Joseph
J
Zabner
Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine.
Peter J
PJ
Gruber
Department of Cardiovascular Sciences, East Carolina University, Greenville, NC.
Mark D
MD
Iannettoni
Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine; Veterans Affairs Medical Center, Iowa City, IA.
Kalpaj
K
Parekh
D006785:Hospitals, University; D006801:Humans; D016040:Lung Transplantation / Q000592:standards; D016730:Program Development; D011787:Quality of Health Care; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000592:standards