Transplant center volume and outcomes after liver retransplantation.
Transplant center volume and outcomes after liver retransplantation.
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DOI：
10.1111/j.1600-6143.2008.02488.x
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发表时间：
2009-02
期刊：
影响因子：
--
通讯作者：
Markmann JF
中科院分区：
文献类型：
--
作者：
Reese PP;Yeh H;Thomasson AM;Shults J;Markmann JF
Liver re-transplantation surgery has a high rate of allograft failure due to patient co-morbidities and technical demands of the procedure. Success of liver re-transplantation could depend on surgeon experience and processes of care that relate to center volume. We performed a retrospective cohort study of adult liver re-transplantation procedures performed from 1/1/1996 through 12/31/2005 using registry data from the Organ Procurement Transplantation Network. The primary outcome was one-year allograft failure. Liver transplant centers were categorized as small, intermediate or high volume by dividing overall liver transplants into three tertiles of approximately equal size. Mean annual volume of overall liver transplants was <50 for low volume centers, 50 – 88 for intermediate volume centers, and >88 for high volume centers. The primary analysis consisted of 3977 liver re-transplantation patients. The unadjusted risk of one-year allograft failure was 37.8%. In multivariable logistic regression, the risk of one-year allograft failure was not significantly different between low (reference), intermediate (O.R. 0.86, CI 0.72–1.03, p=0.11) and high volume centers (O.R. 0.88, CI 0.74–1.04, p=0.14). Results were similar when the analysis was limited to re-transplantation performed >160 days after initial transplantation. Center volume is an imprecise surrogate measure for one-year outcomes after liver re-transplantation.
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