The center effect in liver transplantation in the Eurotransplant region: a retrospective database analysis

the Eurotransplant Liver Intestine Advisory Committee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Apart from donor and recipient risk factors, the effect of center-related factors has significant impact on graft survival after liver transplantation (LT). To investigate this effect in Eurotransplant, a retrospective database analysis was performed, including all LT's in adult recipients (≥18 years) in the Eurotransplant region from 1.1.2007 until 31.12.2013. Additionally, a survey was sent out to all transplant centers requesting information on surgeons’ experience and exposure. In total, 10 265 LT's were included (median follow-up 3.3 years), performed in 39 transplant centers. Funnel plots showed significant differences in graft survival between the transplant centers. After correction for donor and recipient risk, with the Eurotransplant donor risk index (ET-DRI) and the simplified recipient risk index (sRRI) and random effects, these differences diminished. Mean historical volume (in the preceding 5 years) was a significant (P < 0.001), nonlinear marker for graft survival in the multivariate analysis. This study demonstrates that funnel plots can be used for benchmarking purposes in LT. Case-mix correction can be performed with the use of the ET-DRI and sRRI. The center effect encompasses the entire complex process of preoperative workup, operation to follow-up.

Original languageEnglish
Pages (from-to)610-619
Number of pages10
JournalTransplant International
Volume31
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

Fingerprint

Liver Transplantation
Databases
Graft Survival
Tissue Donors
Transplants
Information Centers
Benchmarking
Diagnosis-Related Groups
Multivariate Analysis

Keywords

  • donor risk
  • Europe
  • outcome
  • risk factor

ASJC Scopus subject areas

  • Transplantation

Cite this

The center effect in liver transplantation in the Eurotransplant region : a retrospective database analysis. / the Eurotransplant Liver Intestine Advisory Committee.

In: Transplant International, Vol. 31, No. 6, 01.06.2018, p. 610-619.

Research output: Contribution to journalArticle

the Eurotransplant Liver Intestine Advisory Committee. / The center effect in liver transplantation in the Eurotransplant region : a retrospective database analysis. In: Transplant International. 2018 ; Vol. 31, No. 6. pp. 610-619.
@article{1e0fb6237fcc44c4b485b39ded8aadb6,
title = "The center effect in liver transplantation in the Eurotransplant region: a retrospective database analysis",
abstract = "Apart from donor and recipient risk factors, the effect of center-related factors has significant impact on graft survival after liver transplantation (LT). To investigate this effect in Eurotransplant, a retrospective database analysis was performed, including all LT's in adult recipients (≥18 years) in the Eurotransplant region from 1.1.2007 until 31.12.2013. Additionally, a survey was sent out to all transplant centers requesting information on surgeons’ experience and exposure. In total, 10 265 LT's were included (median follow-up 3.3 years), performed in 39 transplant centers. Funnel plots showed significant differences in graft survival between the transplant centers. After correction for donor and recipient risk, with the Eurotransplant donor risk index (ET-DRI) and the simplified recipient risk index (sRRI) and random effects, these differences diminished. Mean historical volume (in the preceding 5 years) was a significant (P < 0.001), nonlinear marker for graft survival in the multivariate analysis. This study demonstrates that funnel plots can be used for benchmarking purposes in LT. Case-mix correction can be performed with the use of the ET-DRI and sRRI. The center effect encompasses the entire complex process of preoperative workup, operation to follow-up.",
keywords = "donor risk, Europe, outcome, risk factor",
author = "{the Eurotransplant Liver Intestine Advisory Committee} and Blok, {Joris J.} and {de Boer}, {Jacob D.} and Hein Putter and Xavier Rogiers and Guba, {Markus O.} and Strassburg, {Christian P.} and Undine Samuel and {van Hoek}, Bart and Hamming, {Jaap F.} and Braat, {Andries E.} and Berlakovich, {Gabriela A.} and Peter Michielsen and Blaz Trotovsek and Branislav Kocman and L. K{\'o}bori and Jacques Pirenne and {van Rosmalen}, {Marieke D.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1111/tri.13129",
language = "English",
volume = "31",
pages = "610--619",
journal = "Transplant International",
issn = "0934-0874",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - The center effect in liver transplantation in the Eurotransplant region

T2 - a retrospective database analysis

AU - the Eurotransplant Liver Intestine Advisory Committee

AU - Blok, Joris J.

AU - de Boer, Jacob D.

AU - Putter, Hein

AU - Rogiers, Xavier

AU - Guba, Markus O.

AU - Strassburg, Christian P.

AU - Samuel, Undine

AU - van Hoek, Bart

AU - Hamming, Jaap F.

AU - Braat, Andries E.

AU - Berlakovich, Gabriela A.

AU - Michielsen, Peter

AU - Trotovsek, Blaz

AU - Kocman, Branislav

AU - Kóbori, L.

AU - Pirenne, Jacques

AU - van Rosmalen, Marieke D.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Apart from donor and recipient risk factors, the effect of center-related factors has significant impact on graft survival after liver transplantation (LT). To investigate this effect in Eurotransplant, a retrospective database analysis was performed, including all LT's in adult recipients (≥18 years) in the Eurotransplant region from 1.1.2007 until 31.12.2013. Additionally, a survey was sent out to all transplant centers requesting information on surgeons’ experience and exposure. In total, 10 265 LT's were included (median follow-up 3.3 years), performed in 39 transplant centers. Funnel plots showed significant differences in graft survival between the transplant centers. After correction for donor and recipient risk, with the Eurotransplant donor risk index (ET-DRI) and the simplified recipient risk index (sRRI) and random effects, these differences diminished. Mean historical volume (in the preceding 5 years) was a significant (P < 0.001), nonlinear marker for graft survival in the multivariate analysis. This study demonstrates that funnel plots can be used for benchmarking purposes in LT. Case-mix correction can be performed with the use of the ET-DRI and sRRI. The center effect encompasses the entire complex process of preoperative workup, operation to follow-up.

AB - Apart from donor and recipient risk factors, the effect of center-related factors has significant impact on graft survival after liver transplantation (LT). To investigate this effect in Eurotransplant, a retrospective database analysis was performed, including all LT's in adult recipients (≥18 years) in the Eurotransplant region from 1.1.2007 until 31.12.2013. Additionally, a survey was sent out to all transplant centers requesting information on surgeons’ experience and exposure. In total, 10 265 LT's were included (median follow-up 3.3 years), performed in 39 transplant centers. Funnel plots showed significant differences in graft survival between the transplant centers. After correction for donor and recipient risk, with the Eurotransplant donor risk index (ET-DRI) and the simplified recipient risk index (sRRI) and random effects, these differences diminished. Mean historical volume (in the preceding 5 years) was a significant (P < 0.001), nonlinear marker for graft survival in the multivariate analysis. This study demonstrates that funnel plots can be used for benchmarking purposes in LT. Case-mix correction can be performed with the use of the ET-DRI and sRRI. The center effect encompasses the entire complex process of preoperative workup, operation to follow-up.

KW - donor risk

KW - Europe

KW - outcome

KW - risk factor

UR - http://www.scopus.com/inward/record.url?scp=85046715731&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046715731&partnerID=8YFLogxK

U2 - 10.1111/tri.13129

DO - 10.1111/tri.13129

M3 - Article

C2 - 29406577

AN - SCOPUS:85046715731

VL - 31

SP - 610

EP - 619

JO - Transplant International

JF - Transplant International

SN - 0934-0874

IS - 6

ER -