PAs and NPs in liver transplantation: Perceptions, implementation, and effect

Area of Science:

• Transplant Surgery
• Healthcare Management
• Clinical Practice

Background:

• Physician associates (PAs) and nurse practitioners (NPs) play an increasing role in specialized medical fields.
• Their integration into liver transplant programs is not fully characterized, particularly regarding their financial impact.

Purpose of the Study:

• To assess the utilization and perceptions of PAs and NPs in liver transplant centers.
• To determine the financial effect of employing PAs and NPs in liver transplant care.

Main Methods:

• A survey was distributed to leaders of liver transplant programs (performing ≥25 transplants in 2020).
• A single-center retrospective analysis compared length of stay (LOS) and readmission rates before and after implementing a dedicated PA team for liver and simultaneous liver-kidney transplants.
• Statistical analyses included chi-square and t-tests.

Main Results:

• The survey achieved a 77% response rate, with 98% of institutions reporting the use of PAs and NPs.
• The retrospective analysis revealed a significantly shorter mean LOS post-transplant in the cohort with a dedicated PA team (P = .0005).
• No significant difference was observed in 30-day readmission rates.

Conclusions:

• PAs and NPs are broadly integrated into the post-liver transplant care continuum.
• The reduction in LOS suggests that a dedicated PA and NP team may offer a financial benefit and contribute to cost savings in liver transplantation.