Liver transplant volume association with presence of heart and lung transplant programs: analysis of SRTR metrics.

Purpose: We sought to understand how centers transplanting liver only (L0), centers transplanting heart and liver (LH), and centers transplanting liver, heart, and lung (LHL) differ regarding volume, waitlist and post-transplant outcomes.

Methods: Data were collected from the Scientific Registry of Transplant Recipients (SRTR) in July 2023. SRTR star ratings were categorized into five tiers, with one being the lowest tier and five the highest tier.

Results: Median liver transplant volumes were 35 [IQR: 14-51] for L0 centers, 45 [10-75] for LH centers, and 101 [69-131] for LHL centers (p < 0.001). Liver waitlist survival (p = 0.13), waitlist duration (p = 0.31) and 1-year survival ratings (p = 0.32) were comparable across all 3 categories. Annual transplant volume was associated with a higher SRTR waitlist duration rating (p < 0.001) but not with 1-year post-transplant survival (p = 0.51).

Conclusion: The presence of a heart transplant and lung transplant programs in liver transplant centers is associated with higher liver transplant volumes, translating to higher waitlist duration tier ratings for liver recipients, but not to improved 1-year post-transplant survival.