Low volume is associated with worse patient outcomes for pediatric liver transplant centers

Journal of Pediatric Surgery
Elisabeth T TracyJohn E Scarborough

Abstract

An inverse association between hospital procedure volume and postoperative mortality has been demonstrated for a variety of pediatric surgical procedures. The objective of our study was to determine whether such an association exists for pediatric liver transplantation. We performed a retrospective analysis of pediatric liver transplant procedures included in the Scientific Registry of Transplant Recipients over a 7.5-year time period from July 1, 2000, through December 31, 2007. Pediatric liver transplant centers were divided into three volume categories (high, middle, low) based on absolute annual volume. Mean 1-year patient survival rates and aggregate 1-year observed-to-expected (O:E) patient death ratios were calculated for each hospital volume category and then compared using ordered logistic regression and chi square analyses. High-volume pediatric liver transplant centers achieved significantly lower aggregate 1-year O:E patient death ratios than low-volume centers. When freestanding children's hospitals (FCH), children's hospitals within adult hospitals (CAH), and other centers (OC) were considered separately, we found that a significant volume-outcomes association existed among OC centers but not among FCH or CAH cent...Continue Reading

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Citations

Mar 22, 2014·Pediatric Surgery International·Nathan P ZwintscherJohn D Horton
May 20, 2014·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Punkaj GuptaRandall C Wetzel
Mar 1, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Ronen ArnonBenjamin L Shneider
May 24, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Deepak K OzhathilShimul A Shah
Nov 3, 2010·Transplant International : Official Journal of the European Society for Organ Transplantation·Peter SchenkerRichard Viebahn
Aug 29, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J Emond
Jun 12, 2012·The Journal of Surgical Research·James S DavisJuan E Sola
Oct 21, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Abbas RanaChristine A O'Mahony
Mar 3, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A RanaJ A Goss
Jun 21, 2013·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Valeriya V Kettelhut, Preethy Nayar
Nov 18, 2018·Pediatric Transplantation·Christine S HwangMalcolm MacConmara
Jun 7, 2019·Pediatric Transplantation·Lucile MarsacSouhayl Dahmani
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Jan 7, 2021·Clinical Transplantation·Joel T AdlerJoel S Weissman
Oct 30, 2020·Journal of Clinical Medicine·Suk Kyun HongKyung-Suk Suh
Aug 9, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Mounika KannegantiTherese Bittermann

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