Good info for anyone out there Or near the East Coast

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General Comments: On 's Hopkins Hospital In Baltimore MD

The current 90 day and 1 year graft and patient survival data in this

report is for transplants done between January, 2004, and June, 2006.

During this period, we recognized that our program was experiencing

low survival rates, and we made several important changes resulting

in markedly improved outcomes. Specifically we have implemented the

following improvements: 1) We hired an additional cardiothoracic

transplant surgeon, Ashish Shah, M.D. who now serves as the Surgical

Director of Lung Transplantation. 2) We formalized a dedicated

transplant anesthesiology team. 3) We now more carefully align donor

organs with the appropriate recipient characteristics to maximize

survival benefit. 4) We are following strict adherence to the

recommendations and guidelines published in the journal of the

International Society For Heart and Lung Transplantation (ISHLT) for

both candidate selection and donor utilization. 5) We developed a

protocol to screen for occult malignancies in potential recipients

prior to transplant and we are no longer accepting donors with a

history of brain tumors. 6) We implemented a comprehensive quality

improvement review with the hiring of a full-time quality improvement

nurse coordinator for all of our solid organ transplant programs. In

September, 2007, the United Network For Organ Sharing (UNOS)

conducted an extensive peer review of our lung transplant program,

including a comprehensive review of all patient deaths that occurred

over the preceding years. The review was performed in conjunction

with a transplant surgeon, pulmonologist and administrator from three

outside institutions. The group could not identify any major

deficiencies with the program. The reviewers felt that the problems

the program had experienced related to survival were corrected and

they made only a few minor recommendations to decrease vulnerability

to such problems in the future. The reviewers noted that " the lung

transplant team is committed to quality and excellence, communicates

effectively across disciplines, and is highly experienced and

skilled. " The reviewers did not find specific patterns to account for

the lower than expected survival outcomes that had occurred, and felt

that it was primarily the result of transplantation of very sick and

complex patients, not well reflected in the expected survival

calculations. In summary, their review report stated that " the lung

transplant program at the s Hopkins Hospital has already made the

changes necessary to improve patient survival rates " and that " the

corrective actions implemented thus far should have a positive impact

on patient outcomes. " Indeed, these changes have resulted in a

significant improvement in outcomes. All patients receiving a primary

lung transplant during calendar year 2007 are alive and functioning

well. For transplants done during this time (n=21 transplants; 20

patients), the 90 day patient survival is 100%. Given the dedication

and experience of our team together with excellent institutional

support, we expect this improvement to be sustained.