Favorable waitlist and transplant outcomes in transplant centers with a rapid increase in center volume
Kitajima T, Ivanics T, Shamaa T, Shimada S, Collins K, Rizzari M, Yoshida A, Abouljoud M, and Nagai S. Favorable waitlist and transplant outcomes in transplant centers with a rapid increase in center volume. Am J Transplant 2022; 22:44-44.
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.