← Back to December 2016

What Is a Cardiothoracic Transplant Surgeon?

links image

Roger W. Evans, PhD
The United Network for the Recruitment
of Transplantation Professionals
Rochester, MN, USA

I frequently recruit transplant surgeons for transplant centers. For the most part, the recruitment of abdominal transplant surgeons is unambiguous, and relatively straightforward. I can easily describe the position for which I'm recruiting. However, when it comes to so-called "cardiothoracic" transplant surgeons, there is considerable confusion. In this regard, when describing transplant surgeons who have something to do with the chest, people often interchangeably use the following terms: cardiac, cardiovascular, thoracic, cardiothoracic, and cardiopulmonary. In my opinion, it's time to eliminate the ambiguity, and avoid the confusion.

I recently completed a thorough review of the surgical staffing for all adult lung transplant programs in the United States (U.S.). In doing so, I found considerable diversity.

First, let me begin with the obvious. In the United States, a lung transplant surgeon is any qualified and appropriately credentialed surgeon who performs lung transplants at a lung transplant center approved by the United Network for Organ Sharing (UNOS).

Second, going forward, when describing lung transplant surgeons, I believe we should discontinue using the terms "cardiac" and "cardiopulmonary." They add nothing to the discourse.

Third, based on scope of practice, clinical interests, and practice areas, I've concluded that it makes sense to distinguish amongst three categories/types of surgeons performing lung transplants. These categories/types are as follows: (1) cardiovascular surgeons (CVS), (2) thoracic surgeons (TS), and (3) cardiothoracic surgeons (CTS).

Fourth, let me provide the basis for the distinctions I've made. This is accomplished in the following table.

As is apparent from Table 1, my rationale is unequivocal. There are surgeons performing lung transplants in the U.S. who are essentially cardiovascular surgeons (CVS). Other than lung transplants, they do very little by way of thoracic procedures.

There is a second group of lung transplant surgeons, thoracic surgeons (TS), who not only do lung transplants but, in addition, routinely perform a wide array of thoracic surgical procedures. However, unlike their cardiovascular and cardiothoracic lung transplant surgeon colleagues, they do not do heart transplants, or a wide array of cardiovascular procedures.

Lastly, there is a third group of lung transplant surgeons who are truly cardiothoracic surgeons (CTS). These surgeons do both heart and lung transplants, as well as a wide range of both cardiovascular and thoracic surgical procedures.

There are 197 lung transplant surgeons associated with 60 active adult lung transplant programs in the US. Based on my research, I can provide a breakdown on how many lung transplant surgeons fall into each of the categories I have described here. The results are summarized in the following table:

Of the surgeons performing adult lung transplants in the U.S., over half are cardiovascular surgeons, and just over a third are thoracic surgeons. Meanwhile, very few surgeons performing adult lung transplants are truly cardiothoracic surgeons.

I began my research by asking a simple question: what is a cardiothoracic surgeon? I addressed this question in relationship to adult lung transplantation. Given what I found, I feel it is appropriate to ask two additional questions: (1) Who should be doing lung transplants in the first place? (2) Are there variations in patient outcomes based on the type of surgeon who performs lung transplants? ■

Disclosure Statement: The author has no conflicts of interest to disclose.

Share via:

links image    links image    links image    links image