Analysis of differences in outcome of two European liver transplant centers

B. Nemes, Wojtek Polak, Gábor Ther, Herman Hendriks, L. Kóbori, Robert J. Porte, E. Sárváry, Koert P. De Jong, Attila Doros, Zsuzsa Gerlei, Aad P. Van Den Berg, Imre Fehérvári, Dénes Görög, Paul M. Peeters, J. Járay, Maarten J H Slooff

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)372-380
Number of pages9
JournalTransplant International
Volume19
Issue number5
DOIs
Publication statusPublished - May 2006

Fingerprint

Transplants
Survival
Netherlands
Liver
Erythrocyte Transfusion
Hungary
Graft Survival
Hemostasis
Blood Vessels
Multivariate Analysis
Transplantation
Tissue Donors
Morbidity
Kidney
Infection

Keywords

  • Center volume
  • Complications < liver clinical
  • Hungary
  • Indications
  • Liver clinical
  • Liver transplantation
  • Outcome < liver clinical
  • Survival
  • The Netherlands

ASJC Scopus subject areas

  • Transplantation

Cite this

Analysis of differences in outcome of two European liver transplant centers. / Nemes, B.; Polak, Wojtek; Ther, Gábor; Hendriks, Herman; Kóbori, L.; Porte, Robert J.; Sárváry, E.; De Jong, Koert P.; Doros, Attila; Gerlei, Zsuzsa; Van Den Berg, Aad P.; Fehérvári, Imre; Görög, Dénes; Peeters, Paul M.; Járay, J.; Slooff, Maarten J H.

In: Transplant International, Vol. 19, No. 5, 05.2006, p. 372-380.

Research output: Contribution to journalArticle

Nemes, B, Polak, W, Ther, G, Hendriks, H, Kóbori, L, Porte, RJ, Sárváry, E, De Jong, KP, Doros, A, Gerlei, Z, Van Den Berg, AP, Fehérvári, I, Görög, D, Peeters, PM, Járay, J & Slooff, MJH 2006, 'Analysis of differences in outcome of two European liver transplant centers', Transplant International, vol. 19, no. 5, pp. 372-380. https://doi.org/10.1111/j.1432-2277.2006.00287.x
Nemes, B. ; Polak, Wojtek ; Ther, Gábor ; Hendriks, Herman ; Kóbori, L. ; Porte, Robert J. ; Sárváry, E. ; De Jong, Koert P. ; Doros, Attila ; Gerlei, Zsuzsa ; Van Den Berg, Aad P. ; Fehérvári, Imre ; Görög, Dénes ; Peeters, Paul M. ; Járay, J. ; Slooff, Maarten J H. / Analysis of differences in outcome of two European liver transplant centers. In: Transplant International. 2006 ; Vol. 19, No. 5. pp. 372-380.
@article{6d971946e67f4e41910ce05acf70b198,
title = "Analysis of differences in outcome of two European liver transplant centers",
abstract = "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.",
keywords = "Center volume, Complications < liver clinical, Hungary, Indications, Liver clinical, Liver transplantation, Outcome < liver clinical, Survival, The Netherlands",
author = "B. Nemes and Wojtek Polak and G{\'a}bor Ther and Herman Hendriks and L. K{\'o}bori and Porte, {Robert J.} and E. S{\'a}rv{\'a}ry and {De Jong}, {Koert P.} and Attila Doros and Zsuzsa Gerlei and {Van Den Berg}, {Aad P.} and Imre Feh{\'e}rv{\'a}ri and D{\'e}nes G{\"o}r{\"o}g and Peeters, {Paul M.} and J. J{\'a}ray and Slooff, {Maarten J H}",
year = "2006",
month = "5",
doi = "10.1111/j.1432-2277.2006.00287.x",
language = "English",
volume = "19",
pages = "372--380",
journal = "Transplant International",
issn = "0934-0874",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Analysis of differences in outcome of two European liver transplant centers

AU - Nemes, B.

AU - Polak, Wojtek

AU - Ther, Gábor

AU - Hendriks, Herman

AU - Kóbori, L.

AU - Porte, Robert J.

AU - Sárváry, E.

AU - De Jong, Koert P.

AU - Doros, Attila

AU - Gerlei, Zsuzsa

AU - Van Den Berg, Aad P.

AU - Fehérvári, Imre

AU - Görög, Dénes

AU - Peeters, Paul M.

AU - Járay, J.

AU - Slooff, Maarten J H

PY - 2006/5

Y1 - 2006/5

N2 - 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.

AB - 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.

KW - Center volume

KW - Complications < liver clinical

KW - Hungary

KW - Indications

KW - Liver clinical

KW - Liver transplantation

KW - Outcome < liver clinical

KW - Survival

KW - The Netherlands

UR - http://www.scopus.com/inward/record.url?scp=33645960129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645960129&partnerID=8YFLogxK

U2 - 10.1111/j.1432-2277.2006.00287.x

DO - 10.1111/j.1432-2277.2006.00287.x

M3 - Article

C2 - 16623872

AN - SCOPUS:33645960129

VL - 19

SP - 372

EP - 380

JO - Transplant International

JF - Transplant International

SN - 0934-0874

IS - 5

ER -