Failure to rescue in the era of the lung allocation score: The impact of center volume

Asishana A. Osho, Muath M. Bishawi, Elbert E. Heng, Ejiro Orubu, Aaron Amardey-Wellington, Mauricio A. Villavicencio, Masaki Funamoto

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation. Methods: Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume. Results: 17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001). Conclusion: Higher volume lung transplantation centers have lower rates of failure to rescue.

Original languageEnglish
Pages (from-to)793-799
Number of pages7
JournalAmerican Journal of Surgery
Issue number3
StatePublished - Sep 2020


  • Failure to rescue
  • Lung transplantation
  • Mortality
  • Surgical quality
  • Survival


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