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Beyond death and graft survival—Variation in outcomes after liver transplant. Results from the NSQIP transplant beta phase
Author(s) -
Parekh Justin R.,
Greenstein Stuart,
Sudan Debra L.,
Grieco Arielle,
Cohen Mark E.,
Hall Bruce L.,
Ko Clifford Y.,
Hirose Ryutaro
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15357
Subject(s) - medicine , urinary system , transplantation , liver transplantation , incidence (geometry) , surgery , emergency medicine , physics , optics
The National Surgical Quality Program ( NSQIP ) Transplant program was designed by transplant surgeons from the ground up to track posttransplant outcomes beyond basic recipient and graft survival. After an initial pilot phase, the program has expanded to 29 participating sites and enrolled more than 4300 recipient‐donor pairs into the database, including 1444 completed liver transplant cases. In this analysis, surgical site infection ( SSI ), urinary tract infection ( UTI ), and unplanned reoperation/intervention after liver transplantation were evaluated. We observed impressive variation in the crude incidence between sites for SSI (0%‐29%), UTI (0%‐10%), and reoperation/intervention (0%‐57%). After adjustment for donor and recipient factors, at least 1 site was identified as an outlier for each of the analyzed outcomes. For the first time, the field of transplantation has data that demonstrate variation in liver recipient outcomes beyond death and graft survival between sites. More importantly, NSQIP Transplant provides a powerful platform to improve care beyond basic patient and graft survival.