Analysis of differences in outcome of two European liver transplant centers
| Autor: | Zsuzsa Gerlei, Gábor Ther, Koert P. de Jong, Jeno Járay, Robert J. Porte, Eniko Sárváry, Imre Fehérvári, Dénes Görög, Maarten J.H. Slooff, Paul M. J. G. Peeters, Balázs Nemes, Attila Doros, László Kóbori, Herman G. D. Hendriks, Wojtek Polak, Aad P. van den Berg |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Nephrology
Male Multivariate analysis Erythrocytes Time Factors medicine.medical_treatment HUNGARIAN EXPERIENCE Liver transplantation DECONTAMINATION INFECTION center volume Child COMPLICATIONS liver transplantation Graft Survival VENOVENOUS BYPASS VENA-CAVA Middle Aged Europe Treatment Outcome complications < liver clinical Female Adult medicine.medical_specialty Transfusion rate Adolescent survival Blood loss Internal medicine medicine liver clinical Humans Blood Transfusion PRESERVATION Aged Transplantation Hungary outcome < liver clinical indications business.industry MORTALITY the Netherlands Surgery TRANSFUSION REQUIREMENTS Hemostasis Multivariate Analysis VOLUME Complication business |
| Zdroj: | Transplant International, 19(5), 372-380. Wiley |
| ISSN: | 0934-0874 |
| Popis: | Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen, The Netherlands (UMCG). We investigated if such differences could be explained. The 1-, 3- and 5-year patient survival in the UMCG was 86%, 80%, and 77% compared with 65%, 56%, and 55% in SEB. Graft survival at the same time points was 79%, 71%, and 66% in the UMCG and 62%, 55%, and 53% in SEB. Significant differences were present regarding the donor and recipient age, diagnosis mix, disease severity and operation variables, per-operative transfusion rate, vascular complications, postoperative infection rate, and need for renal replacement. To determine factors correlating with survival, a separate uni- and multivariate analysis was performed in each center individually, between study parameters and patient survival. In both centers, peri-operative red blood cell (RBC) transfusion rate was a significant predictor for patient survival. The difference in blood loss can be explained by different operation techniques and shorter operation time in SEB, with consequently less time spent on hemostasis. It was jointly concluded that measures to reduce blood loss by adapting the operation technique might lead to improved survival and reduced morbidity. |
| Databáze: | OpenAIRE |
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