Favorable waitlist and transplant outcomes in transplant centers with a rapid increase in center volume

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Transplant


Background: It is unclear if centers can rapidly increase liver transplant (LT) volume without compromising their post-LT outcomes. This study aims to investigate the eff ects of a rapid increase in center volume on waitlist and post-LT outcomes.

Patients and methods: This study uses data from UNOS registry and evaluated adult patients listed for LT or underwent LT between 2014 and 2019. Patients listed as multi-organ transplant and re-LT were excluded. The “change in LT center volume” was defined by the “volume in 2017-19 (late era) minus volume in 2014-16 (early era)” per center with categorization into three groups: Centers with increased volume (Group A:>60 cases [20 cases/year]), those with equivalent volume (Group B:0-60 cases), and those with decline in volume (Group C:<0 case). Ninety-day waitlist mortality (WLM), LT probability and one-year graft survival were compared between eras in each group.

Results: Of 67,046 patients eligible for waitlist outcome analysis, the late era was associated with a lower risk of 90-day WLM than the early era in all groups. The late era was associated with a higher 90-day LT probability than the early era in Group A and B but not in Group C (Figure 1A and B). Among 39,579 patients, the late era was associated with a lower risk of one-year GL in Group A and C (Figure 1C).

Conclusion: A rapid increase in LT center volume was associated with signifi cant improvements in waitlist outcomes, especially increased transplant probability.





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