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Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation
AIM: To examine the effect of center size on survival differences between simultaneous liver kidney transplantation (SLKT) and liver transplantation alone (LTA) in SLKT-listed patients. METHODS: The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT b...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787677/ https://www.ncbi.nlm.nih.gov/pubmed/29399287 http://dx.doi.org/10.4254/wjh.v10.i1.134 |
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author | Modi, Rohan M Tumin, Dmitry Kruger, Andrew J Beal, Eliza W Hayes, Don Hanje, James Michaels, Anthony J Washburn, Kenneth Conteh, Lanla F Black, Sylvester M Mumtaz, Khalid |
author_facet | Modi, Rohan M Tumin, Dmitry Kruger, Andrew J Beal, Eliza W Hayes, Don Hanje, James Michaels, Anthony J Washburn, Kenneth Conteh, Lanla F Black, Sylvester M Mumtaz, Khalid |
author_sort | Modi, Rohan M |
collection | PubMed |
description | AIM: To examine the effect of center size on survival differences between simultaneous liver kidney transplantation (SLKT) and liver transplantation alone (LTA) in SLKT-listed patients. METHODS: The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Post-transplant survival was evaluated using stratified Cox regression with interaction between transplant type (LTA vs SLKT) and center volume. RESULTS: During the study period, 393 of 4580 patients (9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients (180/393, 46%) than SLKT recipients (1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio (HR) = 2.85; 95%CI: 2.21, 3.66; P < 0.001] in centers performing 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction (HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs performed. CONCLUSION: In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes. |
format | Online Article Text |
id | pubmed-5787677 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-57876772018-02-02 Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation Modi, Rohan M Tumin, Dmitry Kruger, Andrew J Beal, Eliza W Hayes, Don Hanje, James Michaels, Anthony J Washburn, Kenneth Conteh, Lanla F Black, Sylvester M Mumtaz, Khalid World J Hepatol Prospective Study AIM: To examine the effect of center size on survival differences between simultaneous liver kidney transplantation (SLKT) and liver transplantation alone (LTA) in SLKT-listed patients. METHODS: The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Post-transplant survival was evaluated using stratified Cox regression with interaction between transplant type (LTA vs SLKT) and center volume. RESULTS: During the study period, 393 of 4580 patients (9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients (180/393, 46%) than SLKT recipients (1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio (HR) = 2.85; 95%CI: 2.21, 3.66; P < 0.001] in centers performing 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction (HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs performed. CONCLUSION: In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes. Baishideng Publishing Group Inc 2018-01-27 2018-01-27 /pmc/articles/PMC5787677/ /pubmed/29399287 http://dx.doi.org/10.4254/wjh.v10.i1.134 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Prospective Study Modi, Rohan M Tumin, Dmitry Kruger, Andrew J Beal, Eliza W Hayes, Don Hanje, James Michaels, Anthony J Washburn, Kenneth Conteh, Lanla F Black, Sylvester M Mumtaz, Khalid Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title | Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title_full | Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title_fullStr | Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title_full_unstemmed | Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title_short | Effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
title_sort | effect of transplant center volume on post-transplant survival in patients listed for simultaneous liver and kidney transplantation |
topic | Prospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787677/ https://www.ncbi.nlm.nih.gov/pubmed/29399287 http://dx.doi.org/10.4254/wjh.v10.i1.134 |
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