Vilatobá M, Mercado MÁ, Contreras-Saldivar AG, Leal-Villalpando RP, Zamudio-Bautista J, García-Juárez I, Gamboa-Domínguez A

Language: Spanish
References: 26
Page: 443-451
PDF size: 227.81 Kb.

ABSTRACT

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.

REFERENCES

1. Vilatoba M, Eckhoff DE, Contreras JL. Selección del receptor para trasplante hepático. Rev Invest Clin. 2005;57:244-51.

2. Birkmeyer JD, Siewers AE, Finlayson EVA, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128-37.

3. Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of literature. Ann Intern Med. 2002;137:511-20.

4. Reames BN, Ghaferi AA, Birkmeyer JD, et al. Hospital volume and operative mortality in the modern era. Ann Surg. 2014;260:244-51.

5. Hosenpud JD, Breen TJ, Edwards EB, et al. The effect of transplant center volume on cardiac transplant outcome. A report of the United Network for Organ Sharing Scientific Registry JAMA. 1994;271:1844-9.

6. Edwards EB, Roberts JP, McBride MA, et al. The effect of the volume of procedures at transplantation centers on mortality after liver transplantation. N Engl J Med. 1999;341:2049-53.

7. Axelrod D, Guidinger M, McCulloug K, et al. Association of center volume with outcome after liver and kidney transplantation. Am J Transpl. 2004;4:920-7.

8. Ahmad J, Bryce C, Cacciarelli T, et al. Differences in access to liver transplantation: disease severity, waiting time, and transplantation center volume. Ann Intern Med. 2007;146:707-13.

9. Ozhathil D, Fu Li Y, Smith J, et al. Impact of center volume on outcomes of increased-risk liver transplants. Liver Transpl. 2011;17:1191-9.

10. Scarborough J, Pietrobon R, Tuttle-Newhall J, et al. Relationship between provider volume and outcomes for orthotopic liver transplantation. J Gastrointest Surg. 2008;12:1527-33.

11. Northup P, Pruett T, Stukenborg G, et al. Survival after liver transplantation does not correlate with transplant center case volume in the MELD era. Am J Transpl. 2006;6:2455-62.

12. Secretaría de Salud, Salud: México 2006 Información para la rendición de cuentas, 2007. (Septiembre 2017). http://www.salud.gob.mx/unidades/ evaluacion/saludmex2006/SM06.pdf

13. Duro-García V, Niño-Murcia A. Report 2013. Latin America Transplantation. 2013;1:93.

14. Feng S, Goodrich NP, Bragg-Gresham JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transpl. 2006;6:783-90.

15. Diliz H, Orozco H, Kershenobich D, et al. Liver transplantation in Mexico. Report of the first successful case. Rev Gastroenterol Mex. 1991;56:33-8.

16. Varela-Fascinetto G, Hernández-Plata JA, Nieto-Zermeño J, et al. Programa de trasplante hepático pediátrico en el Hospital Infantil de México Federico Gómez. Rev Invest Clin. 2011;63(Suppl 1):57-61.

17. Hernández-Domínguez JM, Holm-Corzo A, Santos-Caballero M, et al. Experience in liver transplantation (1996-2011) at the UMAE, General Hospital Gaudencio Gonzalez Garza, National Medical Center La Raza, Mexican Institute of Social Security, Mexico City, D.F. Rev Invest Clin. 2011;63(Suppl 1):62-6.

18. Cisneros-Garza LE, López-Hernández PA, Muñoz-Ramírez MR, et al. Trasplante hepático en la Unidad Médica de Alta Especialidad Num. 25, IMSS Monterrey. Rev Invest Clin. 2011;63(Suppl 1):69-72.

19. Rodríguez-Montalvo C, Tijerina-Gómez L, Flores-Villalba E, et al. Doce años de trasplante hepático continuo en el Hospital San José-Tec de Monterrey. Rev Invest Clin. 2011;63(Suppl 1):73-8.

20. Pérez-Rodríguez E, Muñoz-Espinosa LE, Zapata-Chavira H, et al. Trasplante hepático ortotópico. Experiencia en el Hospital Universitario de Monterrey, N.L. Rev Invest Clin. 2011;63(Suppl 1):79-84.

21. Bach PB, Cramer LD, Schrag D, et al. The influence of hospital volume on survival after resection for lung cancer. N Engl J Med. 2001;345:181-8.

22. Birmeyer JD, Siewers AE, Finalyson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128-37.

23. Rathore SS, Epstein AJ, Volpp KG, et al. Hospital coronary artery bypass graft surgery volume and patient mortality, 1998-2000. Ann Surg. 2004;239:110-7.

24. Tracy E, Bennett K, Aviki E, et al. Temporal trends in liver transplant centre volume in the USA. HPB. 2009;11:414-21.

25. Reese P, Yeh H, Thomasson A, et al. Transplant center volume and outcomes after liver retransplantation. Am J Transpl. 2009;9:309-17.

26. CENATRA, Reporte Nacional 2012 de la Donación y Trasplantes, 2012. (Septiembre 2017). http://cenatra.salud.gob.mx/descargas/contenido/ trasplante/informe_anual_2014.pdf