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Starting a Lung Transplant ProgramStarting a Lung Transplant Program: A Roadmap for Long-term Excellence

Julia Klesney-Tait, MD, PhD; Michael Eberlein, MD, PhD; Lois Geist, MD, FCCP; John Keech, MD; Joseph Zabner, MD; Peter J. Gruber, MD, PhD; Mark D. Iannettoni, MD, MBA; Kalpaj Parekh, MD
Author and Funding Information

From the Department of Internal Medicine (Drs Klesney-Tait, Eberlein, Geist, and Zabner) and the Department of Cardiothoracic Surgery (Drs Keech, Gruber, and Parekh), University of Iowa Carver College of Medicine, and the Veterans Affairs Medical Center (Drs Geist, Keech, and Parekh), Iowa City, IA; and the Department of Cardiovascular Sciences (Dr Iannettoni), East Carolina University, Greenville, NC.

CORRESPONDENCE TO: Julia Klesney-Tait, MD, PhD, Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242; e-mail: julia-klesney-tait@uiowa.edu


FUNDING/SUPPORT: This work was supported by the National Institutes of Health/National Heart, Lung, and Blood Institute [Grant K08 HL114725-01 to Dr Parekh], the American Heart Association [Grant 0675028N to Dr Klesney-Tait], the Institute for Clinical and Translational Science at the University of Iowa via the National Institutes of Health Clinical and Translational Science Award program [Grant 3UL1RR024979-03S3 to Dr Parekh and 2UL1TR000442-06 to Dr Eberlein]. United Network of Organ Sharing data in this work was supported in part by Health Resources and Services Administration [Contract 234-2005-37011C].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(5):1435-1443. doi:10.1378/chest.14-2241
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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.

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