title: Reducing pediatric liver transplant complications: a potential roadmap for transplant quality improvement initiatives within North America.
abstract: Though robust clinical data are available within transplantation, these data are not used for broad-based, multicentered quality improvement initiates. This article describes a targeted quality improvement initiative within the Studies of Pediatric Liver Transplantation (SPLIT) Registry. Using standard statistical techniques and clinical expertise to adjust for data and statistical reliability, we identified the pediatric liver transplant centers in North America with the lowest hepatic artery thrombosis rate and biliary complication rates. A survey was completed to establish current practices within the entire SPLIT group. Surgeons from the highest performing centers presented a detailed, technically oriented overview of their current practices. The presentations and discussion that followed were recorded and form the basis of the best practices described herein. We frame this work as a unique six-step approach roadmap that may serve as an efficient and cost effective model for novel broad-based quality improvement initiatives within transplantation.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, USA. englesbe@med.umich.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Englesbe
authors.forename: B
authors.initials: B
authors.lastname: Kelly
authors.forename: J
authors.initials: J
authors.lastname: Goss
authors.forename: A
authors.initials: A
authors.lastname: Fecteau
authors.forename: J
authors.initials: J
authors.lastname: Mitchell
authors.forename: W
authors.initials: W
authors.lastname: Andrews
authors.forename: G
authors.initials: G
authors.lastname: Krapohl
authors.forename: J C
authors.initials: JC
authors.lastname: Magee
authors.forename: G
authors.initials: G
authors.lastname: Mazariegos
authors.forename: S
authors.initials: S
authors.lastname: Horslen
authors.forename: J
authors.initials: J
authors.lastname: Bucuvalas
mesh_terms: D019985:Benchmarking; D002648:Child; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D033181:Information Dissemination; D016031:Liver Transplantation / Q000009:adverse effects*; D009656:North America; D011183:Postoperative Complications / Q000517:prevention & control*; D013927:Thrombosis / Q000517:prevention & control