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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
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Textbook Outcomes in Liver Transplantation.
Dimitrios Moris1, Brian I Shaw1, Jared Gloria1
1Department of Surgery, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA.
World Journal of Surgery
|June 4, 2020
Summary
Defining a textbook outcome (TO) for liver transplantation (LT) showed it was achieved in 31% of patients. Achieving TO significantly reduced hospitalization costs, though long-term outcomes were similar.
Area of Science:
- Transplantation Surgery
- Quality Improvement
- Health Economics
Background:
- Textbook outcome (TO) is an emerging quality benchmark in surgery, representing an ideal hospitalization.
- Defining TO for liver transplantation (LT) is crucial for standardizing care quality.
Purpose of the Study:
- To establish the first definition of textbook outcome (TO) for liver transplantation (LT).
- To assess the association of TO with clinical outcomes and healthcare costs in LT patients.
Main Methods:
- A retrospective cohort study of 231 LT patients (2014-2017) was conducted.
- TO was defined by clinician consensus, including freedom from mortality, graft failure, rejection, readmission, prolonged stay, high transfusion, and major complications.
Main Results:
- 31% (71/231) of LT patients achieved TO.
- The most common reasons for failing TO were 30-day readmission (37%) and reoperation (32%).
- Patients achieving TO had significantly lower hospitalization costs (approx. $50,000 less for the transplant episode).
Conclusions:
- This study presents the first definition of TO for LT.
- Achieving TO in LT is linked to reduced initial hospitalization costs but not necessarily improved long-term survival.
- Further multi-institutional studies are needed to validate this TO definition in LT.
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