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Lung Transplant Outcomes in the Veterans Health Administration
John O Barron1, Lucy Thuita2, Eugene H Blackstone3
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
The Annals of Thoracic Surgery
|October 11, 2025
Summary
Veterans receiving lung transplants through the Veterans Health Administration (VA) program show survival rates comparable to non-veterans. This indicates the VA facilitates quality lung transplant care for its patients.
Area of Science:
- Cardiology and Thoracic Surgery
- Transplantation Medicine
- Health Services Research
Background:
- The Veterans Health Administration (VA) collaborates with academic centers for lung transplants, involving travel and shared care.
- This model may impact clinical care and survival for end-stage lung disease patients.
- A comparison of survival outcomes between veterans and non-veterans, and between VA and non-VA programs, is warranted.
Purpose of the Study:
- To compare survival after lung transplant waitlisting and transplantation between veterans and non-veterans.
- To evaluate survival differences for veterans undergoing care through VA versus non-VA programs.
Main Methods:
- Analysis of the Organ Procurement and Transplantation Network lung transplant database (January 2006 - March 2020).
- Inclusion of 31,302 waitlisted and 25,790 transplanted adults.
- Weighted matching used to assess survival, comparing 416 waitlisted veterans (303 in VA program) and 363 transplanted veterans (268 in VA program) against non-veterans.
Main Results:
- One-year waitlist survival: veterans 83% vs. non-veterans 80% (P=.27).
- Five-year post-transplant survival: veterans 62% vs. non-veterans 58% (P=.065).
- Survival for veterans at VA vs. non-VA programs was comparable at both waitlist and post-transplant stages (P > .05 for all comparisons).
Conclusions:
- Veteran survival from lung transplant listing and post-transplant is comparable to non-veterans.
- Veterans treated within the VA lung transplant program demonstrate survival outcomes similar to those treated outside the VA system.
- These findings suggest the VA lung transplant program effectively provides quality care to its patients.
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