J. Price1, D. Williams1, R. Murthy1, J. Waters1, W. Ring1, M. E. Jessen1, M. Peltz1, M. Wait1 1University Of Texas Southwestern Medical Center,Cardiovascular And Thoracic Surgery,Dallas, TX, USA
Introduction: At training institutions, residents often assist with single or bilateral lung transplants. We sought to evaluate the short-term outcomes for these patients, comparing the results when implantation is performed by attending surgeons or when a resident is the implanting surgeon for one side if bilateral or for the entire single lung. We hypothesized that resident participation did not adversely affect outcomes after lung transplantation.
Methods: 243 lung transplant patients at a single center were reviewed. All patients underwent single (SLT) or bilateral lung transplant (BLT). The implanting surgeon and warm implantation time (WIT) were recorded for each side if bilateral or for the single lung, comparing Attending Only (AO) to Resident Participation (RP). We reviewed pre-, intra-, and post-operative variables. Groups were described by mean and standard deviation and compared by t-test, with p-value <0.05 considered significant.
Results: For BLT patients, age and lung allocation score (LAS) did not differ between the groups. While total WIT was significantly shorter in the AO group, cardiopulmonary bypass (CPB) rate, packed red blood cell (pRBC) requirement, duration of intubation, intensive care unit (ICU) stay, postoperative length of stay (LOS), primary graft dysfunction (PGD) grade, and 30-day mortality did not differ between the AO and RP groups. In SLT patients, the age again was similar, but the LAS was significantly higher in the RP group. However, WIT, CPB rate, pRBC requirement, duration of intubation, ICU stay, postoperative LOS, PGD grade, and 30-day mortality did not differ between the two groups. Table 1 summarizes this data.
Conclusion: Lung transplantation is a time-sensitive operation, and often residents are not allowed to perform the donor lung implantation due to this concern. These results show that residents, with proper attending supervision, can perform these difficult procedures with minimal increase in warm implantation time and no compromise in short-term outcomes for these complex patients.
