دورية أكاديمية
Defining Benchmarks in Liver Transplantation: A Multicenter Outcome Analysis Determining Best Achievable Results
| العنوان: | Defining Benchmarks in Liver Transplantation: A Multicenter Outcome Analysis Determining Best Achievable Results |
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| المؤلفون: | Muller, Xavier, Marcon, Francesca, Sapisochin, Gonzalo, Marquez, Max, Dondero, Federica, Rayar, Michel, Doyle, Majella M. B., Callans, Lauren, Li, Jun, Nowak, Greg, Allard, Marc-Antoine, Jochmans, Ina, Jacskon, Kyle, Beltrame, Magali Chahdi, Van Reeven, Marjolein, Iesari, Samuele, Cucchetti, Alessandro, Sharma, Hemant, Staiger, Roxane D., Raptis, Dimitri A., Petrowsky, Henrik, De Oliveira, Michelle, Hernandez-Alejandro, Roberto, Pinna, Antonio D., Lerut, Jan, Polak, Wojciech G., De Santibañes, Eduardo, De Santibañes, Martín, Cameron, Andrew M., Pirenne, Jacques, Cherqui, Daniel, Adam, René A., Ericzon, Bö-Göran, Nashan, Bjoern, Olthoff, Kim, Shaked, Avi, Chapman, William C., Boudjema, Karim, Soubrane, Olivier, Paugam-Burtz, Catherine, Greig, Paul D., Grant, David R., Carvalheiro, Amanda, Muiesan, Paolo, Dutkowski, Philipp, Puhan, Milo, Clavien, Pierre-Alain |
| المساهمون: | Muller, Xavier, Marcon, Francesca, Sapisochin, Gonzalo, Marquez, Max, Dondero, Federica, Rayar, Michel, Doyle, Majella M.B., Callans, Lauren, Li, Jun, Nowak, Greg, Allard, Marc-Antoine, Jochmans, Ina, Jacskon, Kyle, Beltrame, Magali Chahdi, Van Reeven, Marjolein, Iesari, Samuele, Cucchetti, Alessandro, Sharma, Hemant, Staiger, Roxane D., Raptis, Dimitri A., Petrowsky, Henrik, De Oliveira, Michelle, Hernandez-Alejandro, Roberto, Pinna, Antonio D., Lerut, Jan, Polak, Wojciech G., De Santibañes, Eduardo, De Santibañes, Martín, Cameron, Andrew M., Pirenne, Jacque, Cherqui, Daniel, Adam, René A., Ericzon, Bö-Göran, Nashan, Bjoern, Olthoff, Kim, Shaked, Avi, Chapman, William C., Boudjema, Karim, Soubrane, Olivier, Paugam-Burtz, Catherine, Greig, Paul D., Grant, David R., Carvalheiro, Amanda, Muiesan, Paolo, Dutkowski, Philipp, Puhan, Milo, Clavien, Pierre-Alain* |
| سنة النشر: | 2018 |
| المجموعة: | IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: | benchmark, complication, liver transplantation, morbidity, outcome, Surgery |
| الوصف: | Objective: To propose benchmark outcome values in liver transplantation, serving as reference for assessing individual patients or any other patient groups. Background: Best achievable results in liver transplantation, that is, benchmarks, are unknown. Consequently, outcome comparisons within or across centers over time remain speculative. Methods: Out of 7492 liver transplantation performed in 17 international centers from 3 continents, we identified 2024 low risk adult cases with a laboratory model for end-stage liver disease score ≤20 points, a balance of risk score ≤9, and receiving a primary graft by donation after brain death. We chose clinically relevant endpoints covering intra- and postoperative course, with a focus on complications graded by severity including the complication comprehensive index (CCI ®). Respective benchmarks were derived from the median value in each center, and the 75 percentile was considered the benchmark cutoff. Results: Benchmark cases represented 8% to 49% of cases per center. One-year patient-survival was 91.6% with 3.5% retransplantations. Eighty-two percent of patients developed at least 1 complication during 1-year follow-up. Biliary complications occurred in one-fifth of the patients up to 6 months after surgery. Benchmark cutoffs were ≤4 days for ICU stay, ≤18 days for hospital stay, ≤59% for patients with severe complications (≥ Grade III) and ≤42.1 for 1-year CCI ®. Comparisons with the next higher risk group (model for end stage liver disease 21-30) disclosed an increase in morbidity but within benchmark cutoffs for most, but not all indicators, while in patients receiving a second graft from 1 center (n = 50) outcome values were all outside of benchmark values. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high with half of patients developing severe complications during 1-year follow-up. Benchmark cutoffs targeting morbidity parameters offer a valid tool to assess higher risk groups. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | STAMPA |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28885508; info:eu-repo/semantics/altIdentifier/wos/WOS:000429103500028; volume:267; issue:3; firstpage:419; lastpage:425; numberofpages:7; journal:ANNALS OF SURGERY; http://hdl.handle.net/11585/642810Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85042412332; http://journals.lww.com/annalsofsurgery/pages/default.aspxTest |
| DOI: | 10.1097/SLA.0000000000002477 |
| الإتاحة: | https://doi.org/10.1097/SLA.0000000000002477Test http://hdl.handle.net/11585/642810Test http://journals.lww.com/annalsofsurgery/pages/default.aspxTest |
| رقم الانضمام: | edsbas.23DF4103 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/SLA.0000000000002477 |
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