title: Impact of a learning curve model in kidney transplantation on functional outcome and surgical complications in a small volume centre: does size really matter?
abstract: OBJECTIVE
  To evaluate surgical complications and functional results of deceased-donor renal transplantations (DDRT) in a small centre dependent on the surgeons level of experience and to derive a leaning-curve model for DDRT.
  
  
  METHODS
  Three hundred and ninety-two recipients underwent DDRT at the Department of Urology, Bonn University. Operative procedures were performed by 18 various urological surgeons grouped in 5 levels of experience (LOE). Perioperative data, complications and graft survival after 12 months were recorded depending on LOEs.
  
  
  RESULTS
  Operative time and warm ischaemia time significantly decreased after an experience of 40 DDRT. Complication rates and graft function after 12 months did not differ between all LOEs.
  
  
  CONCLUSIONS
  Kidney transplantation in a small centre is a safe and effective procedure even if performed by surgeons under education. As a crucial finding, a surgeon climbing his learning curve becomes faster but not necessarily better.
authors: Department of Urology, Bonn University, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Guido.Fechner@ukb.uni-bonn.de
authors: Guido
authors: G
authors: Fechner
authors: Ilja
authors: I
authors: Seifert
authors: Stefan
authors: S
authors: Hauser
authors: Stefan C
authors: SC
authors: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D006085:Graft Survival; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D059032:Learning Curve; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D052096:Warm Ischemia; D055815:Young Adult