Liver transplantation center in Mexico with low-volume and excellent results

被引:8
作者
Vilatoba, Mario [1 ]
Angel Mercado, Miguel [2 ]
Gabriel Contreras-Saldivar, Alan [1 ]
Paulino Leal-Villalpando, Rafael [3 ]
Zamudio-Bautista, Jorge [3 ]
Garcia-Juarez, Ignacio [4 ]
Gamboa-Dominguez, Armando [5 ]
机构
[1] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Trasplantes, Mexico City, DF, Mexico
[2] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Direcc Cirugia, Mexico City, DF, Mexico
[3] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Anestesiol, Mexico City, DF, Mexico
[4] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Mexico City, DF, Mexico
[5] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Patol, Mexico City, DF, Mexico
来源
GACETA MEDICA DE MEXICO | 2017年 / 153卷 / 04期
关键词
Transplant; Liver; Results; Low-volume; HOSPITAL VOLUME; MORTALITY; OUTCOMES; SURVIVAL;
D O I
10.24875/GMM.17002673
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Orthotopic liver transplantation (OLT) is the treatment of choice for end stage liver disease. Many studies show an inverse relationship between the number of procedures and operative mortality. The objective of the study is to show the results of our center and determine if it can have comparable results to high volumen centers. This is a retrospective study which analyzed the information of patients with OLT at our institution from 1985 to December 31, 2012. Depending on date of transplantation, the study was divided into three stages. Stage 1: from 1985 to 1999. Stage 2: from 2000 to 2007. Stage 3: from 2008 to 2012. In the 1, 2 and 3 stage 22, 37 and 56 OLT were performed respectively. Perioperative mortality was significantly lower between Stage 3 vs. Stage 1 and 2 (3.5% vs. 50% and 21.7%, p = 0.001). Patient survival was also better at 1 and 5 years at Stage 3 (94.4%, 87.8%) vs. era 2 (77.6%, 66.17%) and Stage 1 (47% and 29%) (p = 0.001). In conclusion, the present results of OLT at our program are excellent despite being a low-volume center.
引用
收藏
页码:443 / 451
页数:9
相关论文
共 25 条
[1]   Differences in access to liver transplantation: Disease severity, waiting time, and transplantation center volume [J].
Ahmad, Jawad ;
Bryce, Cindy L. ;
Cacciarelli, Thomas ;
Roberts, Mark S. .
ANNALS OF INTERNAL MEDICINE, 2007, 146 (10) :707-713
[2]   Association of center volume with outcome after liver and kidney transplantation [J].
Axelrod, DA ;
Guidinger, MK ;
McCullough, KP ;
Leichtman, AB ;
Punch, JD ;
Merion, RM .
AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (06) :920-927
[3]   The influence of hospital volume on survival after resection for lung cancer [J].
Bach, PB ;
Cramer, LD ;
Schrag, D ;
Downey, RJ ;
Gelfand, SE ;
Begg, CB .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (03) :181-188
[4]   Hospital volume and surgical mortality in the United States. [J].
Birkmeyer, JD ;
Siewers, AE ;
Finlayson, EVA ;
Stukel, TA ;
Lucas, FL ;
Batista, I ;
Welch, HG ;
Wennberg, DE .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (15) :1128-1137
[5]  
CENATRA, 2017, REP NAC 2012 DON TRA
[6]  
Cisneros-Garza LE, 2011, REV INVEST CLIN S1, V63, P69
[7]  
Diliz H, 1991, Rev Gastroenterol Mex, V56, P33
[8]  
Duro-Garcia V, 2013, LATIN AM TRANSPLANTA, V1, P93
[9]   The effect of the volume of procedures at transplantation centers on mortality after liver transplantation. [J].
Edwards, EB ;
Roberts, JP ;
McBride, MA ;
Schulak, JA ;
Hunsicker, LG .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (27) :2049-2053
[10]   Characteristics associated with liver graft failure: The concept of a donor risk index [J].
Feng, S ;
Goodrich, NP ;
Bragg-Gresham, JL ;
Dykstra, DM ;
Punch, JD ;
DebRoy, MA ;
Greenstein, SM ;
Merion, RM .
AMERICAN JOURNAL OF TRANSPLANTATION, 2006, 6 (04) :783-790