The Hidden Gem: The Costa Rica Lung Transplant Program
Bibliographic record
Abstract
Purpose: more than 4000 lung transplants (LTx) are performed yearly around the world. However, there is only one transplant center in Central America. We aimed to characterize the epidemiology of our LTx recipients and to describe the outcomes of the program. Methods: This study includes all first-time, adult LTx recipients from 2019-July 2023 were included in this study. We conducted a comprehensive analysis of the data using descriptive statistics. Results: During the last 4 years, our center has performed 14 bilateral LTx of which 57% were female. The primary indication was Interstitial Lung Disease in 77% of cases, while emphysema, combined pulmonary fibrosis, and emphysema and bronchiectasis accounted for the remaining cases, each at 7%. The recipient's mean age was 46 years, ranging from 27 to 65 years. At the time of transplant, 7% of recipients were Cytomegalovirus recipients -, and 21% required the Toronto Desensitation Protocol (plasmapheresis, immunoglobulin, and thymoglobulin) due to a positive Virtual Crossmatch. 7% were bridge to transplant and 29% required post-op ECMO. 60% developed primary graft dysfunction grade 3 at 72 hours. The 30 days survival was 86% and the 1 year survival was 79%. Only one patient required temporary renal replacement therapy. The average of days of hospitalizations was 32. Among the patients alive beyond 6 months, 12.5% developed chronic allograft dysfunction at 18 months and 12.5% developed low baseline allograft dysfunction. Additionally, 21% of recipients experience acute cellular rejection. Conclusion: This study demonstrates that even LTx is a complex procedure, our small program has made significant progress in providing Central American patients with first-world opportunities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".