The history of lung transplantation in Hong Kong

Hsin, Michael; Wong, Chi Fong; Yan, See Wan; Fan, Katherine; Ho, Cally Ka-Lai; Bhatia, Inderjeet; Au, Wing‐Kuk

doi:10.21037/jtd.2018.04.118

Cited by 3 publications

(4 citation statements)

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“…Missing data in the present cohort was not excessive at 4.16% and were tackled by multiple imputations. However, our study was limited due to the relatively small sample size due to the relatively small service volume of lung transplantation in our city 21 . In addition, being a city with a predominant Asian population, might limit the generalizability of our data to the other part of the world.…”

Section: Discussionmentioning

confidence: 97%

“…However, our study was limited due to the relatively small sample size due to the relatively small service volume of lung transplantation in our city. 21 In addition, being a city with a predominant Asian population, might limit the generalizability of our data to the other part of the world. An additional multicenter study involving different countries may be needed to confirm our findings.…”

Section: Discussionmentioning

confidence: 98%

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The hemodynamic characteristics of severe chronic lung disease referred for lung transplantation

et al. 2022

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Severe pulmonary hypertension (PH) is not common even in patients with severe chronic lung disease (CLD) but data on hemodynamic characteristics among patients with severe CLD is scarce. All adult patients who had right heart catheterization for lung transplant assessment for severe CLD in the only lung transplant service and for PAH management in the only tertiary pulmonary hypertension service in Hong Kong from 2010 to 2020 were included and classified into CLD group and PAH group. Patient characteristics and hemodynamic parameters were analyzed. There were 153 patients included with 106 patients in the CLD group and 47 in the PAH group. There were only 19.8% of the patients in the CLD group had severe pulmonary hypertension. Patients in the CLD group had significantly lower systolic pulmonary arterial pressure (PAPs), lower mean pulmonary arterial pressure (PAPm), higher cardiac index, and lower PVR when compared with the PAH group ( p < 0.001). The area under curve (AUC) of PAPs, PAPm, and PVR were excellent, 0.973, 0.970, and 0.938, respectively for discrimination between CLD and PAH on receiver operator characteristics curve analysis. Optimal cutoff values were 55.5 mmHg, 35.5 mmHg, and 6.1 Wood Units for PAPs, PAPm, and PVR with Youden Index 0.85, 0.80, and 0.82, respectively. There were distinct hemodynamic characteristics between the CLD group and the PAH group. Systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance are useful to discriminate between the phenotype of severe CLD and PAH.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

The hemodynamic characteristics of severe chronic lung disease referred for lung transplantation

et al. 2022

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“…We showed that the APACHE IV score had satisfactory predictive performance for hospital mortality after ECMO, while the ICU LOS of our cohort was consistently longer than predicted. There may be characteristics in the Hong Kong healthcare infrastructure that lead to systematic over-or under-performance of actual outcomes, such as the relative lack of destination therapy including organ transplantation after end-stage organ failure (25), the finding that no patient over 10 years was bridged from V-V ECMO to lung transplantation affirms this observation (26). The low costs of hospital stay in publicly funded healthcare institutions may skew length of stay data.…”

Section: Discussionmentioning

confidence: 99%

Effect of hospital case volume on clinical outcomes of patients requiring extracorporeal membrane oxygenation: a territory-wide longitudinal observational study

Ng¹,

Ip²,

Fang³

et al. 2022

J Thorac Dis

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Background: The utilization of extracorporeal membrane oxygenation (ECMO) has increased rapidly around the world. Being an overall low-volume high-cost form of therapy, the effectiveness of having care delivered in segregated units across a geographical locality is debatable.Methods: All adult extracorporeal membrane oxygenation cases admitted to public hospitals in Hong Kong between 2010 and 2019 were included. "High-volume" centers were defined as those with >20 extracorporeal membrane oxygenation cases in the respective calendar year, while "low-volume" centers were those with ≤20. Clinical outcomes of patients who received extracorporeal membrane oxygenation care in high-volume centers were compared with those in low-volume centers.Results: A total of 911 patients received extracorporeal membrane oxygenation-297 (32.6%) veno-arterial extracorporeal membrane oxygenation, 450 (49.4%) veno-venous extracorporeal membrane oxygenation, and 164 (18.0%) extracorporeal membrane oxygenation-cardiopulmonary resuscitation. The overall hospital mortality was 456 (50.1%). The annual number of extracorporeal membrane oxygenation cases in high-and low-volume centers were 29 and 11, respectively. Management in a high-volume center was not significantly associated with hospital mortality (adjusted odds ratio (OR) 0.86, 95% confidence interval (CI): 0.61-1.21, P=0.38), or with intensive care unit mortality (adjusted OR 0.76, 95% CI: 0.54-1.06, P=0.10) compared with a low-volume center. Over the 10-year period, the overall observed mortality was similar to the Acute Physiology And Chronic Health Evaluation IV-predicted mortality, with no significant difference in the standardized mortality ratios between high-and low-volume centers (P=0.46). Conclusions:In a territory-wide observational study, we observed that case volumes in extracorporeal membrane oxygenation centers were not associated with hospital mortality. Maintaining standards of care in low-volume centers is important and improves preparedness for surges in demand.

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“…Among indication categories, LAM, bronchiolitis obliterans (BO), and interstitial lung diseases have shown the best survival, while the worse came from pulmonary circulation diseases. The age range of potential candidates for evaluation has been expanded to 65 in recent years (26).…”

Section: Investigation On Practice Of Lung Transplantation In Asiamentioning

confidence: 99%

China lung transplantation developing: past, present and future

Wu¹,

Hu²,

Chen³

et al. 2020

Ann Transl Med

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Lung transplantation in China has been developing for almost 40 years . The pioneers of this procedure experienced struggles and obstacles upon accomplishment of the initial 20 cases of lung transplantation. Like the expanding process of transplant programs elsewhere in western countries and other regions in Asia, transplant teams in China have found their own way to step forward, with the establishment of the two largest centers in Beijing and Wuxi. Since 2015, which was a novel start and milestone for transplant affairs in China, the pace of transplant volume and comparable quality of care for lung transplant recipients have increased noticeably. We reviewed the advancement of lung transplantation programs and registry setup in China and indicated that more socioeconomic factors and human care aspects needed to be considered to benefit Chinese recipients, which may further inspire the modification of criteria of listing and organ utilization based on East Asian cultural and traditional origins.

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The history of lung transplantation in Hong Kong

Cited by 3 publications

References 1 publication

The hemodynamic characteristics of severe chronic lung disease referred for lung transplantation

The hemodynamic characteristics of severe chronic lung disease referred for lung transplantation

Effect of hospital case volume on clinical outcomes of patients requiring extracorporeal membrane oxygenation: a territory-wide longitudinal observational study

China lung transplantation developing: past, present and future

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