Variation of Liver Transplant Practice and Outcomes During Public Holidays in the United States: Analysis of United Network for Organ Sharing Registry

Authors

Tayseer M. Shamaa, Henry Ford HealthFollow
Toshihiro Kitajima, Henry Ford HealthFollow
Tommy Ivanics, Henry Ford HealthFollow
Shingo Shimada, Henry Ford HealthFollow
Adhnan Mohamed, Henry Ford HealthFollow
Sirisha Yeddula, Henry Ford HealthFollow
Michael Rizzari, Henry Ford HealthFollow
Kelly Collins, Henry Ford HealthFollow
Atsushi Yoshida, Henry Ford HealthFollow
Marwan S. Abouljoud, Henry Ford HealthFollow
Shunji Nagai, Henry Ford HealthFollow

Recommended Citation

Shamaa TM, Kitajima T, Ivanics T, Shimada S, Mohamed A, Yeddula S, Rizzari M, Collins K, Yoshida A, Abouljoud M, and Nagai S. Variation of Liver Transplant Practice and Outcomes During Public Holidays in the United States: Analysis of United Network for Organ Sharing Registry. Transplant Direct 2023; 9(4):e1463.

Document Type

Article

Publication Date

4-1-2023

Publication Title

Transplant Direct

Abstract

It has been reported that patients hospitalized outside regular working hours have worse outcomes. This study aims to compare outcomes following liver transplantation (LT) performed during public holidays and nonholidays.

METHODS: We analyzed the United Network for Organ Sharing registry data for 55 200 adult patients who underwent an LT between 2010 and 2019. Patients were grouped according to LT receipt during public holidays ±3 d (n = 7350) and nonholiday periods (n = 47 850). The overall post-LT mortality hazard was analyzed using multivariable Cox regression models.

RESULTS: LT recipient characteristics were similar between public holidays and nonholidays. Compared with nonholidays, deceased donors during public holidays had a lower donor risk index (median [interquartile range]: holidays 1.52 [1.29-1.83] versus nonholidays 1.54 [1.31-1.85]; P = 0.001) and shorter cold ischemia time (median [interquartile range]: holidays 5.82 h [4.52-7.22] versus nonholidays 5.91 h [4.62-7.38]; P < 0.001). Propensity score matching 4-to-1 was done to adjust for donor and recipient confounders (n = 33 505); LT receipt during public holidays (n = 6701) was associated with a lower risk of overall mortality (hazard ratio 0.94 [95% confidence interval, 0.86-0.99]; P = 0.046). The number of livers that were not recovered for transplant was higher during public holidays compared with nonholidays (15.4% versus 14.5%, respectively; P = 0.03).

CONCLUSIONS: Although LT performed during public holidays was associated with improved overall patient survival, liver discard rates were higher during public holidays compared with nonholidays.

Medical Subject Headings

Transplant and Abdominal Surgery

PubMed ID

37009167

Volume

9

Issue

4

First Page

1463

Last Page

1463