Effect of Institutional Kidney Transplantation Case-Volume on Post-Transplant Graft Failure: a Retrospective Cohort Study
Journal of Korean Medical Science
;
: e260-2019.
Article
in English
| WPRIM
| ID: wpr-765097
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- ( 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; P < 0.001) and medium-volume centers (aOR, 1.87; 95% CI, 1.57–2.23; P < 0.001) compared to high-volume centers. Low-volume centers had significantly higher mortality (aOR, 1.75; 95% CI, 1.15–2.66; P = 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 (P < 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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Odds Ratio
/
Retrospective Studies
/
Cohort Studies
/
Mortality
/
Organ Transplantation
/
Kidney Transplantation
/
Hospital Mortality
/
Transplants
/
Dialysis
/
Graft Survival
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2019
Type:
Article
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