Effect of Institutional Kidney Transplantation Case-Volume on Post-Transplant Graft Failure: a Retrospective Cohort Study

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2019 Oct 19

PMID 31625292

Citations 4

Authors

Hye Won Oh

Eun Jin Jang

Ga Hee Kim

Seokha Yoo

Hannah Lee

Tae Yoon Lim

Hansol Kim

Ho Geol Ryu

Affiliations

Soon will be listed here.

Abstract

Background: The impact of institutional case volume to graft failure rate after adult kidney transplantation is relatively unclear compared to other solid organ transplantations.

Methods: A retrospective cohort study of 13,872 adult kidney transplantations in Korea was performed. Institutions were divided into low- (< 24 cases/year), medium- (24-60 cases/year), and high- (> 60 cases/year) volume centers depending on the annual case volume. One-year graft failure rate was defined as the proportion of patients who required dialysis or re-transplantation at one year after transplantation. Postoperative in-hospital mortality and long-term graft survival were also measured.

Results: After adjustment, one year graft failure was higher in low-volume centers significantly (adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.26-1.78; < 0.001) and medium-volume centers (aOR, 1.87; 95% CI, 1.57-2.23; < 0.001) compared to high-volume centers. Low-volume centers had significantly higher mortality (aOR, 1.75; 95% CI, 1.15-2.66; = 0.01) than that of high-volume centers after adjustment. Long-term graft survival of up to 9 years was superior in high-volume centers compared to low- and medium-volume centers ( < 0.001).

Conclusion: Higher-case volume centers were associated with lower one-year graft failure rate, lower in-hospital mortality, and higher long-term graft survival after kidney transplantation.

Citing Articles

Associations of Perioperative Red Blood Cell Transfusion With Outcomes of Kidney Transplantation in Korea Over a 16-Year Period.

Kim Y, Kim B, Kang M, Nam H, Ko D, Park Y J Korean Med Sci. 2023; 38(28):e212.

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Simultaneous Heart-Kidney Transplant-Does Hospital Experience With Heart Transplant or Kidney Transplant Have a Greater Impact on Patient Outcomes?.

Catalano M, Pupovac S, Jhaveri K, Stevens G, Hartman A, Yu P Transpl Int. 2023; 36:10854.

PMID: 37091962 PMC: 10116866. DOI: 10.3389/ti.2023.10854.

Impact of institutional case volume of solid organ transplantation on patient outcomes and implications for healthcare policy in Korea.

Kang C, Ryu H Korean J Transplant. 2023; 37(1):1-10.

PMID: 37064771 PMC: 10090822. DOI: 10.4285/kjt.23.0010.

Dominant predictors of early post-transplant outcomes based on the Korean Organ Transplantation Registry (KOTRY).

Jeong J, Koo T, Ro H, Lee D, Lee D, Oh J Sci Rep. 2022; 12(1):8706.

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