Proximity to transplant center and outcome among liver transplant patients.

Webb, Gwilym J and Hodson, James and Chauhan, Abhishek and O'Grady, John and Neuberger, James M and Hirschfield, Gideon M and Ferguson, James W (2019) Proximity to transplant center and outcome among liver transplant patients. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 19 (1). pp. 208-220. ISSN 1600-6143. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their USB Athens login IDs

Full text not available from this repository.
Official URL: https://onlinelibrary.wiley.com/doi/epdf/10.1111/a...

Abstract

In the United States, distance from liver transplant center correlates with worsened outcomes; the effects of geography elsewhere are unassessed. We performed a national registry analysis of United Kingdom listings for liver transplantation (1995-2014) and assessed whether travel time to transplant center correlates with outcome. There were 11 188 listings assessed (8490 transplanted), with a median travel time to center of 60 minutes (range 36-86). Of the national population, 3.38 × 10 (55.1%) reside ≥60 minutes from a center, and 7.65 × 10 (12.5%) >119 minutes. After competing risk analysis, increasing travel time was associated with an increased risk of death after listing (subdistribution hazard ratios relative to <60 minutes of 1.33 for 60-119 and 1.27 for >119 minutes; P < 0.001) and reduced likelihood of transplantation or recovery (0.94 and 0.86; P < 0.001). Among those transplanted, travel time was not associated with retransplant-free survival (P = 0.532). We used our model to examine optimal placement of a new center and identify a single site with a total travel time reduction of ≈10%. Our findings of disparities in accessibility of liver transplantation showed worse outcomes following listing in those distant from their transplant center, and our description of a method to model a new center complement existing data and support similar analyses of other networks.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their USB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
Related URLs:
Depositing User: Stephen Yates
Date Deposited: 21 Apr 2020 13:34
Last Modified: 10 Jul 2020 13:30
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3002

Actions (login required)

View Item View Item