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Liver Transplant Program Quality Index Which Accounts for Transplant Rate; the Power of Numbers!, A

C. Rochon, A. Lally, M. Brown, P. Sheiner

Surgery/Transplantation, Hartford Hospital, Hartford, CT

Meeting: 2013 American Transplant Congress

Abstract number: A610

It is unclear whether patients and grafts survival (PS and GS) rates alone are indices of Quality. Programs who cherry pick could have outstanding PS/GS while fair quality organs get wasted and higher risk patients die on the wait list. We have developed a Quality Index (QI), which includes transplant rates (TR) and compared randomly selected liver transplant programs using their SRTR data. The QI was calculated using the following formula (Observed OPS/ Expected EPS) x (0.7 if below expected, 1 if as expected or 1.3 if above expected)x (OGS/ EGS)x (0.7, 1 or 1.3)x (OTR/ETR). High volume centers (HVC) were defined has centers doing >85 yearly liver transplants. The QI value ranged from 0.35 to 3.19 with a median of 0.60. The QI was higher in center who perfom living donor liver transplants than in centers who do not (1.17 vs 1.00). High volume centers also had a QI higher than lower volume centers (0.95 vs 1.40). The percentage of organ sharing was higher in program with a QI <1 (22%) vs programs with a QI> than 1. There was no difference in the usage of older donors related to QI. Interestingly, centers with QI >1 had a significantly shorter length of stay (median 7.3 days) vs QI<1 (median 13.75 days). Adding transplant rate to outcomes markers of quality like graft and patients survival may prove useful in enhancing and assessing quality in liver transplantation.

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To cite this abstract in AMA style:

Rochon C, Lally A, Brown M, Sheiner P. Liver Transplant Program Quality Index Which Accounts for Transplant Rate; the Power of Numbers!, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/liver-transplant-program-quality-index-which-accounts-for-transplant-rate-the-power-of-numbers-a/. Accessed June 7, 2025.

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