Analysis of differences in outcome of two European liver transplant centers

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

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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 1 2006

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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

Nemes, B., Polak, W., Ther, G., Hendriks, H., Kóbori, L., Porte, R. J., Sárváry, E., De Jong, K. P., Doros, A., Gerlei, Z., Van Den Berg, A. P., Fehérvári, I., Görög, D., Peeters, P. M., Járay, J., & Slooff, M. J. H. (2006). Analysis of differences in outcome of two European liver transplant centers. Transplant International, 19(5), 372-380. https://doi.org/10.1111/j.1432-2277.2006.00287.x