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The impact of waiting time on liver transplant outcomes
1Department of Health Policy and Management, Emory University, Atlanta, GA 30322, USA.
Objective:
To measure the impact of patient waiting time on the probability of graft failure following liver transplantation.
Data Sources:
Observations on all patients receiving transplants between 1995 and 1997 collected by the United Network for Organ Sharing.
Study Design:
This study uses a two-stage probit algorithm. The first stage is an ordinary least squares regression of controls and indicators of patient blood type (the instrument set) on waiting time. The second uses the predicted value from the first regression in a probit analysis where the dependent variable is graft failure.
Principal Findings:
Waiting time has a statistically and clinically significant effect on the probability of graft failure following transplantation. Waiting 50 additional days for a transplant increases the probability of graft failure at one year by between one and two percentage points.
Conclusions:
Policies to reduce waiting times will yield clinical benefits beyond decreasing the length of time patients spend in poor health.