Long Distance Relationships – Does The Geographic Distance From The Transplant Centre Affect Lung Transplant Outcomes?

Espeed Khoshbin, Joseph Battle, Hazel Muse, Kirstie Wallace, George Ditchburn, Gareth Parry, Stephen Clark

Background
Patient and referring physician choice often means that some lung transplant recipients may reside considerable distances from their transplant centre compared with others. We reviewed a single centre experience to examine the effect of distance from home to the transplant centre on outcome. 

Methods
We conducted a single institution retrospective study of 480 adult patients who received lung transplants for any indication from Jan 2002 and Dec 2016. The distance from the transplant centre was calculated and analysed in three groups: A) 0 to 75 miles, B) 76 to 150 miles and C) >150 miles. Multivariate analysis was used to compare the groups. Kaplan-Meier plots compared survival and Pearson correlation was used to test the correlation between variables. 

Results
Patients were categorised according to our three distance groups A, B and C. The groups were compatible with respect to age, sex, diagnosis and the type of operation and there was no significant difference in the survival in the short, medium or long term illustrated by Kaplan-Meier plot in Figure 1. The mean survival in years did not differ significantly between the groups. 

Conclusions
Long-distance management of lung transplant recipients is successful and is not associated with an increase in adverse outcomes. By itself, distance should not represent a barrier to transplantation and patients can be confident in their choice of transplant centre even if it is far away.