title: The center effect: is bigger better?
abstract: Grouping US kidney transplant centers according to the number of transplants performed during the past 10 years into those that reported more than 1,000 transplants and all others showed: 1. Ten-year graft survival rates at larger centers were no more than 5% higher than those at other centers. 2. Graft survival rates were most similar between the 2 center groups when the donor was an HLA-identical sibling or when the recipient had chronic glomerulonephritis. 3. Larger centers had a slightly but noticeably higher graft survival rate when the patient had juvenile onset diabetes, when the donor was older than age 60 and when the donor was a spouse. 4. Most differences in graft survival rates between larger and all other centers were apparent only 2-3 years after transplantation, suggesting that the differences reflect long-term management of the patients or that an historical difference existed that has disappeared in recent years.
authors.forename: P I
authors.initials: PI
authors.lastname: Terasaki
authors.forename: J M
authors.initials: JM
authors.lastname: Cecka
mesh_terms: D001741:Black or African American; D002102:Cadaver; D006085:Graft Survival; D006650:Histocompatibility Testing; D006761:Hospitals / Q000145:classification; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D014481:United States; D044465:White People