The weekend effect in liver transplantation

Area of Science:

• Hepatology
• Transplantation Surgery
• Clinical Outcomes Research

Background:

• The weekend effect is a documented phenomenon where hospital admissions on weekends are associated with increased patient risk.
• Limited data exists on whether this effect extends to complex procedures like orthotopic liver transplantation (oLT).

Purpose of the Study:

• To investigate the existence and impact of the weekend effect on orthotopic liver transplantation outcomes.
• To compare one-year patient and graft survival rates for oLT performed on weekdays versus weekends.

Main Methods:

• A retrospective analysis of deceased donor liver transplants performed between 2006 and 2016 in the Eurotransplant region.
• Patients were categorized into weekday (Monday-Friday) and weekend (Saturday-Sunday) transplant groups.
• One-year patient survival, graft survival, rejection rates, primary non-function, and re-transplantation rates were primary outcome measures.

Main Results:

• A total of 364 deceased donor livers were transplanted into 329 patients; 246 (74.77%) on weekdays and 83 (25.23%) on weekends.
• Key patient and donor characteristics, including age, ischemia time, and MELD score, were comparable between groups.
• One-year patient and graft survival rates were similar, with no significant differences in rejection, primary non-function, or re-transplantation rates between weekday and weekend transplants.

Conclusions:

• This study provides the first evidence from the Eurotransplant region indicating no weekend effect on orthotopic liver transplantation.
• Standardized transplant protocols and specialized multidisciplinary teams may mitigate potential weekend-related risks.
• Orthotopic liver transplantation is a safe and successful procedure, irrespective of the day of the week it is performed.