Regional transplant rates depend more on physician-dependent variables than on proximity to transplant center.

Autor: Payani E; Department of General, Visceral and Transplant Surgery, LMU Klinikum Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Börner N; Department of General, Visceral and Transplant Surgery, LMU Klinikum Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Kolliogiannis D; Department of General, Visceral and Transplant Surgery, LMU Klinikum Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Brunner S; Department of Surgery, University Medical Center Regensburg, Regensburg, Germany., Klein I; Department of Surgery, University of Würzburg, Würzburg, Germany., Ehmer U; Internal Medicine II, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany., Denk G; LMU Klinikum, MED 2, Munich, Germany., Lange CM; LMU Klinikum, MED 2, Munich, Germany., Ograja K; Transplant Center Munich, LMU Klinikum, Munich, Germany., Dietrich P; Transplant Center Erlangen-Nürnberg, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany., Werner J; Department of General, Visceral and Transplant Surgery, LMU Klinikum Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Guba M; Department of General, Visceral and Transplant Surgery, LMU Klinikum Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany. Markus.Guba@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 May 12; Vol. 408 (1), pp. 191. Date of Electronic Publication: 2023 May 12.
DOI: 10.1007/s00423-023-02874-9
Abstrakt: Purpose: The objective of this work was to uncover inequalities in access to liver transplantation in Bavaria, Germany.
Methods: For this purpose, the annual transplantation rate per 1 million inhabitants for the respective districts was determined from the aggregated postal codes of the place of residence of transplanted patients. The variables examined were proximity and travel time to the nearest transplant center, as well as the care category of the regional hospital. In addition, we assessed whether the head of gastroenterology at the regional hospital through which liver transplant candidates are referred was trained at a liver transplant center.
Results: We could not demonstrate a direct relationship between proximity or travel time to the nearest transplant center and access to liver transplantation. Multivariate regression analysis shows that liver transplant training (p < 0.0001) of the chief physician (gastroenterologist) of the regional hospital was the most decisive independent factor for access to liver transplantation within a district.
Conclusion: We show that the transplant training experience of the head of gastroenterology at a regional hospital is an independent factor for the regional transplantation rate. Therefore, it appears important to maintain some liver transplant expertise outside the transplant centers in order to properly identify and assign potential transplant candidates for transplantation.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: