title: Analysis of differences in outcome of two European liver transplant centers.
abstract: Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen, The Netherlands (UMCG). We investigated if such differences could be explained. The 1-, 3- and 5-year patient survival in the UMCG was 86%, 80%, and 77% compared with 65%, 56%, and 55% in SEB. Graft survival at the same time points was 79%, 71%, and 66% in the UMCG and 62%, 55%, and 53% in SEB. Significant differences were present regarding the donor and recipient age, diagnosis mix, disease severity and operation variables, per-operative transfusion rate, vascular complications, postoperative infection rate, and need for renal replacement. To determine factors correlating with survival, a separate uni- and multivariate analysis was performed in each center individually, between study parameters and patient survival. In both centers, peri-operative red blood cell (RBC) transfusion rate was a significant predictor for patient survival. The difference in blood loss can be explained by different operation techniques and shorter operation time in SEB, with consequently less time spent on hemostasis. It was jointly concluded that measures to reduce blood loss by adapting the operation technique might lead to improved survival and reduced morbidity.
authors.affiliation: Department of Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary. nemes@trans.sote.hu
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.forename: Wojtek
authors.initials: W
authors.lastname: Polak
authors.forename: Gábor
authors.initials: G
authors.lastname: Ther
authors.forename: Herman
authors.initials: H
authors.lastname: Hendriks
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Porte
authors.forename: Enikõ
authors.initials: E
authors.lastname: Sárváry
authors.forename: Koert P
authors.initials: KP
authors.lastname: de Jong
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Gerlei
authors.forename: Aad P
authors.initials: AP
authors.lastname: van den Berg
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: Paul M
authors.initials: PM
authors.lastname: Peeters
authors.forename: Jenõ
authors.initials: J
authors.lastname: Járay
authors.forename: Maarten J H
authors.initials: MJ
authors.lastname: Slooff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D002648:Child; D004912:Erythrocytes / Q000378:metabolism; D005060:Europe; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013997:Time Factors; D016896:Treatment Outcome