Published by the Students of Johns Hopkins since 1896
October 26, 2020

Survival for heart and lung transplant patients not affected by time of surgery

June 13, 2011

Among surgeons performing emergency procedures, fatigue is endemic. Surgeon fatigue is triggered by unpredictable sleeping schedules, emotional stress, missed meals, and complicated procedures that last hours. Thus, it has been long associated with unfavorable surgical turnouts.

To illustrate the extent of sleep deprivation in the operating room, a Harvard Medical School sleep study compared performing surgery after pulling an all-nighter to driving with a blood alcohol content of 0.1%- that’s considered legally drunk in all 50 states!

Similarly, surgery done at night has been stigmatized as producing a larger degree of medical complications in comparison with surgery performed in the daytime. A surgeon is perceived to be more alert and fresh during the day, qualities that generally link to increased competency.

Contrary to the belief that night surgery produces worse outcomes, a large-scale Hopkins study suggests that in the case of heart and lung transplants, daytime and nighttime surgeries have equal success rates.

The study comprises more than 27,000 cases of heart and lung transplants performed over the course of 10 years at medical centers across the country.

Of the 16,573 patients who received a heart transplant, half had surgery during the day, and half at night. One year after the surgery, the survival rates for the day and night patients were 88% and 87.7%, respectively.

The findings were essentially equivalent in the 10,545 cases of lung transplants, with an 83.8% survival rate for day patients compared to 82.6% for night patients.

Heart and lung transplants are contingent upon the availability of organs, and therefore performed with little regard to the clock or the surgeon’s sleeping schedule. Furthermore, these surgeries typically average 10 hours to complete.

The success rate of heart and lung transplants is a testament to the skill and dedication of the surgeons, and can provide reassurance for patients undergoing these surgeries, no matter the time of day.

-Mali Wiederkehr, Science & Technology Editor

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