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Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011
BACKGROUND: Regional variations in kidney and liver transplant outcomes have been reported, but their causes remain largely unknown. This study investigated variations in kidney and liver cold ischemia times (CITs) across organ procurement organizations (OPO) as potential causes of variations in tra...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648555/ https://www.ncbi.nlm.nih.gov/pubmed/26594661 http://dx.doi.org/10.1097/TXD.0000000000000529 |
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author | Koizumi, Naoru DasGupta, Debasree Patel, Amit V. Smith, Tony E. Mayer, Jeremy D. Callender, Clive Melancon, Joseph K. |
author_facet | Koizumi, Naoru DasGupta, Debasree Patel, Amit V. Smith, Tony E. Mayer, Jeremy D. Callender, Clive Melancon, Joseph K. |
author_sort | Koizumi, Naoru |
collection | PubMed |
description | BACKGROUND: Regional variations in kidney and liver transplant outcomes have been reported, but their causes remain largely unknown. This study investigated variations in kidney and liver cold ischemia times (CITs) across organ procurement organizations (OPO) as potential causes of variations in transplant outcomes. METHODS: This retrospective study analyzed the Standard Transplant Analysis and Research data of deceased donor kidney (n = 61,335) and liver (n = 39,285) transplants performed between 2003 and 2011. The CIT variations between the 2 types of organs were examined and compared. Factors associated with CIT were explored using multivariable regressions. Spearman rank tests were used to associate CIT with graft failure at the OPO level. RESULTS: Significant CIT variations were found across OPOs for both organs (P < 0.05). The variation was particularly large for kidney CIT. Those OPOs with longer average kidney CIT were likely to have a lower graft survival rate (P = 0.01). For liver, this association was insignificant (P = 0.23). The regression analysis revealed sharp contrasts between the factors associated with kidney and liver CITs. High-risk kidney transplant recipients and marginal kidneys were associated with longer average CIT. The reverse was true for liver transplants. CONCLUSIONS: Large variations in kidney CIT compared to liver CIT may indicate that there is a room to reduce kidney CIT. Reducing kidney CIT through managerial improvements could be a cost-effective way to improve the current transplant system. |
format | Online Article Text |
id | pubmed-4648555 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-46485552016-08-01 Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 Koizumi, Naoru DasGupta, Debasree Patel, Amit V. Smith, Tony E. Mayer, Jeremy D. Callender, Clive Melancon, Joseph K. Transplant Direct Original Clinical Science BACKGROUND: Regional variations in kidney and liver transplant outcomes have been reported, but their causes remain largely unknown. This study investigated variations in kidney and liver cold ischemia times (CITs) across organ procurement organizations (OPO) as potential causes of variations in transplant outcomes. METHODS: This retrospective study analyzed the Standard Transplant Analysis and Research data of deceased donor kidney (n = 61,335) and liver (n = 39,285) transplants performed between 2003 and 2011. The CIT variations between the 2 types of organs were examined and compared. Factors associated with CIT were explored using multivariable regressions. Spearman rank tests were used to associate CIT with graft failure at the OPO level. RESULTS: Significant CIT variations were found across OPOs for both organs (P < 0.05). The variation was particularly large for kidney CIT. Those OPOs with longer average kidney CIT were likely to have a lower graft survival rate (P = 0.01). For liver, this association was insignificant (P = 0.23). The regression analysis revealed sharp contrasts between the factors associated with kidney and liver CITs. High-risk kidney transplant recipients and marginal kidneys were associated with longer average CIT. The reverse was true for liver transplants. CONCLUSIONS: Large variations in kidney CIT compared to liver CIT may indicate that there is a room to reduce kidney CIT. Reducing kidney CIT through managerial improvements could be a cost-effective way to improve the current transplant system. Lippincott Williams & Wilkins 2015-08-13 /pmc/articles/PMC4648555/ /pubmed/26594661 http://dx.doi.org/10.1097/TXD.0000000000000529 Text en Copyright © 2015 The Authors. Transplantation Direct. Published by Wolters Kluwer Health, Inc This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Original Clinical Science Koizumi, Naoru DasGupta, Debasree Patel, Amit V. Smith, Tony E. Mayer, Jeremy D. Callender, Clive Melancon, Joseph K. Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title | Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title_full | Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title_fullStr | Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title_full_unstemmed | Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title_short | Geographic Variation in Cold Ischemia Time: Kidney Versus Liver Transplantation in the United States, 2003 to 2011 |
title_sort | geographic variation in cold ischemia time: kidney versus liver transplantation in the united states, 2003 to 2011 |
topic | Original Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648555/ https://www.ncbi.nlm.nih.gov/pubmed/26594661 http://dx.doi.org/10.1097/TXD.0000000000000529 |
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