Seokha Yoo1, Eun Jin Jang2, Nam-Joon Yi3, Ga Hee Kim4, Dal Ho Kim4, Hannah Lee1, Chul-Woo Jung1, Ho Geol Ryu1. 1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Information Statistics, Andong National University, Gyeongsangbuk-do, Republic of Korea. 3. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 4. Department of Statistics, Kyungpook National University, Daegu, Republic of Korea.
Abstract
BACKGROUND: The relationship between institutional case volume and clinical outcomes after living donor liver transplantation is not clarified. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 7073 adult living donor liver transplantations were performed at 50 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >50, 10 to 50, and <10. RESULTS: In-hospital mortality rates in the high-, medium-, and low-volume centers were 2.8%, 4.1%, and 6.7%, respectively. After adjustment, in-hospital mortality was significantly higher in low-volume centers (adjusted odds ratio, 2.287; 95% confidence interval, 1.471-3.557; P < 0.001) and medium-volume centers (adjusted odds ratio, 1.676; 95% confidence interval, 1.089-2.578; P = 0.019) compared with high-volume centers. Long-term survival for up to 9 years was better, and intensive care unit and hospital length of stay were shorter in high-volume centers. CONCLUSIONS: Centers with higher case volume (>50 liver transplantations/year) had better outcomes after living donor liver transplantation, including in-hospital mortality and long-term mortality compared with centers with lower case volume (≤50 liver transplantations/year).
BACKGROUND: The relationship between institutional case volume and clinical outcomes after living donor liver transplantation is not clarified. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 7073 adult living donor liver transplantations were performed at 50 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >50, 10 to 50, and <10. RESULTS: In-hospital mortality rates in the high-, medium-, and low-volume centers were 2.8%, 4.1%, and 6.7%, respectively. After adjustment, in-hospital mortality was significantly higher in low-volume centers (adjusted odds ratio, 2.287; 95% confidence interval, 1.471-3.557; P < 0.001) and medium-volume centers (adjusted odds ratio, 1.676; 95% confidence interval, 1.089-2.578; P = 0.019) compared with high-volume centers. Long-term survival for up to 9 years was better, and intensive care unit and hospital length of stay were shorter in high-volume centers. CONCLUSIONS: Centers with higher case volume (>50 liver transplantations/year) had better outcomes after living donor liver transplantation, including in-hospital mortality and long-term mortality compared with centers with lower case volume (≤50 liver transplantations/year).
Authors: Koji Matsuo; Shinya Matsuzaki; Rachel S Mandelbaum; Kazuhide Matsushima; Maximilian Klar; Brendan H Grubbs; Lynda D Roman; Jason D Wright Journal: J Surg Oncol Date: 2019-11-19 Impact factor: 3.454
Authors: Seung-Young Oh; Eun Jin Jang; Ga Hee Kim; Hannah Lee; Nam-Joon Yi; Seokha Yoo; Bo Rim Kim; Ho Geol Ryu Journal: PLoS One Date: 2021-08-05 Impact factor: 3.240