Impact of Providing Care Locally Compared to at a Transplant Center for Pre-And Posttransplant Liver Patients

R. Shahbazov,¹ K. Knapp,² S. Tsutsui,² A. Nickkholgh,¹ P. Northup,³ J. Oberholzer,¹ D. Maluf,¹ M. Shiffman,⁴ S. Pelletier.¹

¹Surgery, University of Virginia Healthsystem, Charlottesville, VA
²University of Virginia School of Medicine, University of Virginia Healthsystem, Charlottesville, VA
³Gastroenterology, University of Virginia Healthsystem, Charlottesville, VA
⁴Secours Liver Institute of Richmond, Secours Liver Institute of Richmond, Richmond, VA.

Meeting: 2018 American Transplant Congress

Abstract number: C247

Keywords: Liver failure, Liver transplantation, Outcome, Survival

Session Information

Session Name: Poster Session C: Liver: Recipient Selection

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

There is a potential to improve patient satisfaction as well as access to liver transplantation (LT). AIM: This study evaluated outcomes of LT recipients whose care was directed locally at a non-LT center compared to patients who received care at the LT center.

MATERIAL AND METHODS: Consecutive adult LT patient's outcomes at a single transplant center were studied over an 8-year period. The local group was referred by a single hepatology practice based at a health system independent of the transplant center. RESULTS: During the study period, 2383 patients were referred to the LT center. Among them 2215 (92.9%) had care directed by the LT center and 168 (7.1%) patients were referred by the local hepatology practice. Of the 457 patients receiving LTs, 403 (88.1%) were cared for mainly by the transplant center and 54 (11.9%) received the majority of their care locally. The LT center candidates had an average calculated MELD score at listing of 19.1 vs 21.8 for local candidates. Average MELD scores at transplantation were 21.8, but the local group had a higher average MELD score of 24.7 (p=0.2568). Post-transplant and total length of hospital stay were less for patients referred by the local group compared to patients seen at the LT center (9.9 vs 11.8 days and 11.5 vs 14.3 days, respectively, p=0.0047). 30 day and 90 day readmission rates were similar between two groups (12.7% vs 7.4% and 23.1% vs 14.8%, respectively; p=0.3254, p=1254). Comparison of graft survival at 1 year (88.5% vs 91.5%, p=0.6547), and 3 years (88.5% vs 86.5%; 0.4142); as well as patient survival at 1 year (88.5% vs 92.1%; p=0.5891), and 3 years (88.5% vs 86.9%; p=0.6987) were similar too.

CONCLUSION: Excellent outcomes can be achieved for patients with ESLD receiving their pre- and post-transplant medical care locally and focusing only perioperative care at the LT center. These results were achieved within a system with regular communication between the two groups.

CITATION INFORMATION: Shahbazov R., Knapp K., Tsutsui S., Nickkholgh A., Northup P., Oberholzer J., Maluf D., Shiffman M., Pelletier S. Impact of Providing Care Locally Compared to at a Transplant Center for Pre-And Posttransplant Liver Patients Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Shahbazov R, Knapp K, Tsutsui S, Nickkholgh A, Northup P, Oberholzer J, Maluf D, Shiffman M, Pelletier S. Impact of Providing Care Locally Compared to at a Transplant Center for Pre-And Posttransplant Liver Patients [abstract]. https://atcmeetingabstracts.com/abstract/impact-of-providing-care-locally-compared-to-at-a-transplant-center-for-pre-and-posttransplant-liver-patients/. Accessed November 21, 2024.

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