NDLI: Proximity to transplant center and outcome among liver transplant patients

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Proximity to transplant center and outcome among liver transplant patients

Content Provider	Scilit
Author	O’Grady, John Webb, Gwilym J. Hodson, James Chauhan, Abhishek Neuberger, James M. Hirschfield, Gideon M. Ferguson, James W.
Copyright Year	2018
Description	Journal: American Journal of Transplantation In the United States, distance from liver transplant center correlates with worsened outcomes; the effects of geography elsewhere are unassessed. We performed a national registry analysis of United Kingdom listings for liver transplantation (1995‐2014) and assessed whether travel time to transplant center correlates with outcome. There were 11 188 listings assessed (8490 transplanted), with a median travel time to center of 60 minutes (range 36‐86). Of the national population, 3.38 × 107 (55.1%) reside ≥60 minutes from a center, and 7.65 × 106 (12.5%) >119 minutes. After competing risk analysis, increasing travel time was associated with an increased risk of death after listing (subdistribution hazard ratios relative to 119 minutes; P < 0.001) and reduced likelihood of transplantation or recovery (0.94 and 0.86; P < 0.001). Among those transplanted, travel time was not associated with retransplant‐free survival (P = 0.532). We used our model to examine optimal placement of a new center and identify a single site with a total travel time reduction of ≈10%. Our findings of disparities in accessibility of liver transplantation showed worse outcomes following listing in those distant from their transplant center, and our description of a method to model a new center complement existing data and support similar analyses of other networks.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491997/pdf
Ending Page	220
Page Count	13
Starting Page	208
e-ISSN	16006143
DOI	10.1111/ajt.15004
Journal	American Journal of Transplantation
Issue Number	1
Volume Number	19
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2018-06-20
Access Restriction	Open
Subject Keyword	Journal: American Journal of Transplantation Business / Management Clinical Research / Practice Health Services and Outcomes Research Liver Transplantation / Hepatology Organ Transplantation in General Patient Characteristics
Content Type	Text

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