Literature DB >> 22828744

Impact of a learning curve model in kidney transplantation on functional outcome and surgical complications in a small volume centre: does size really matter?

Guido Fechner1, Ilja Seifert, Stefan Hauser, Stefan C Müller.   

Abstract

PURPOSE: To evaluate surgical complications and functional results of deceased-donor renal transplantations (DDRT) in a small centre dependent on the surgeons level of experience and to derive a leaning-curve model for DDRT.
METHODS: Three hundred and ninety-two recipients underwent DDRT at the Department of Urology, Bonn University. Operative procedures were performed by 18 various urological surgeons grouped in 5 levels of experience (LOE). Perioperative data, complications and graft survival after 12 months were recorded depending on LOEs.
RESULTS: Operative time and warm ischaemia time significantly decreased after an experience of 40 DDRT. Complication rates and graft function after 12 months did not differ between all LOEs.
CONCLUSIONS: Kidney transplantation in a small centre is a safe and effective procedure even if performed by surgeons under education. As a crucial finding, a surgeon climbing his learning curve becomes faster but not necessarily better.

Entities:  

Mesh:

Year:  2012        PMID: 22828744     DOI: 10.1007/s11255-012-0254-5

Source DB:  PubMed          Journal:  Int Urol Nephrol        ISSN: 0301-1623            Impact factor:   2.370


  14 in total

1.  Impact of surgeon experience on complication rates and functional outcomes of 484 deceased donor renal transplants: a single-centre retrospective study.

Authors:  Hannes Cash; Torsten Slowinski; Anette Buechler; Annaeva Grimm; Frank Friedersdorff; Danilo Schmidt; Kurt Miller; Markus Giessing; T Florian Fuller
Journal:  BJU Int       Date:  2012-03-09       Impact factor: 5.588

2.  Does initial learning curve compromise outcomes for robot-assisted radical cystectomy? A critical evaluation of the first 60 cases while establishing a robotics program.

Authors:  Kyle A Richards; Karim Kader; Joseph A Pettus; John J Smith; Ashok K Hemal
Journal:  J Endourol       Date:  2011-08-11       Impact factor: 2.942

3.  Impact of recipient and donor nonimmunologic factors on the outcome of deceased donor kidney transplantation.

Authors:  M F Shaheen; F A M Shaheen; B Attar; K Elamin; H Al Hayyan; A Al Sayyari
Journal:  Transplant Proc       Date:  2010 Jan-Feb       Impact factor: 1.066

Review 4.  The relationship between volume or surgeon specialty and outcome in the surgical treatment of lung cancer: a systematic review and meta-analysis.

Authors:  Erik M von Meyenfeldt; Gea A Gooiker; Willem van Gijn; Piet N Post; Cornelis J H van de Velde; Rob A E M Tollenaar; Houke M Klomp; Michel W J M Wouters
Journal:  J Thorac Oncol       Date:  2012-07       Impact factor: 15.609

Review 5.  Overconfidence as a cause of diagnostic error in medicine.

Authors:  Eta S Berner; Mark L Graber
Journal:  Am J Med       Date:  2008-05       Impact factor: 4.965

6.  Developing a laparoscopic radical prostatectomy service: defining the learning curve.

Authors:  Nikhil Vasdev; Antoine Kass-Iliyya; Ameet Patel; Geoff Bedford; Anna O'Riordon; Mark I Johnson; Garrett C Durkan; Naeem A Soomro
Journal:  J Endourol       Date:  2012-03-02       Impact factor: 2.942

7.  Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.

Authors:  R A Wolfe; V B Ashby; E L Milford; A O Ojo; R E Ettenger; L Y Agodoa; P J Held; F K Port
Journal:  N Engl J Med       Date:  1999-12-02       Impact factor: 91.245

8.  Hospital volume is a determinant of postoperative complications, blood transfusion and length of stay after radical or partial nephrectomy.

Authors:  Maxine Sun; Marco Bianchi; Quoc-Dien Trinh; Firas Abdollah; Jan Schmitges; Claudio Jeldres; Shahrokh F Shariat; Markus Graefen; Francesco Montorsi; Paul Perrotte; Pierre I Karakiewicz
Journal:  J Urol       Date:  2011-12-15       Impact factor: 7.450

9.  Low annual caseloads of United States surgeons conducting radical prostatectomy.

Authors:  Caroline J Savage; Andrew J Vickers
Journal:  J Urol       Date:  2009-12       Impact factor: 7.450

10.  Urological complications: analysis and management of 1525 consecutive renal transplantations.

Authors:  G Zavos; P Pappas; T Karatzas; N P Karidis; J Bokos; K Stravodimos; E Theodoropoulou; J Boletis; A Kostakis
Journal:  Transplant Proc       Date:  2008-06       Impact factor: 1.066

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  1 in total

1.  Impact of surgical training and surgeon's experience on early outcome in kidney transplantation.

Authors:  Michael Thomas; Markus Rentsch; Moritz Drefs; Joachim Andrassy; Bruno Meiser; Manfred Stangl; Karl-Walter Jauch; Markus Guba
Journal:  Langenbecks Arch Surg       Date:  2013-03-22       Impact factor: 3.445

  1 in total

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