Defining Benchmarks in Liver Transplantation

作者：Xavier Muller, Francesca Marcon, Gonzalo Sapisochín, Max Marquez, Fédérica Dondero, Michel Rayar, Majella M.B. Doyle, Lauren Callans, Jun Li, Greg Nowak, Marc-Antoine Allard, Ina Jochmans, Kyle Jacskon, M. Chahdi Beltrame, Marjolein van Reeven, Samuele Iesari, Alessandro Cucchetti, Hemant Sharma, Roxane D. Staiger, Dimitri Aristotle Raptis, Henrik Petrowsky, Michelle de Oliveira, Roberto Hernandez‐Alejandro, Antonio D. Pinna, Jan Lerut, Wojciech G. Polak, Eduardo de Santibáñes, Martín de Santibañes, Andrew M. Cameron, Jacques Pirenne, Daniel Cherqui, René Adam, Bo-Göran Ericzon, Bjoern Nashan, Kim M. Olthoff, A. Shaked, William C. Chapman, Karim Boudjéma, Olivier Soubrane, Cathérine Paugam‐Burtz, Paul D. Greig, David Grant, A. Carvalheiro, Paolo Muiesan, Philipp Dutkowski, Milo A. Puhan, Pierre-Alain Clavien · 发表于：Annals of Surgery · 年份：2017 · DOI：10.1097/sla.0000000000002477 · 被引用次数：255 · 研究领域：Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation、Renal Transplantation Outcomes and Treatments

: This multicentric study of 17 high-volume centers presents 12 benchmark values for liver transplantation. Those values, mostly targeting markers of morbidity, were gathered from 2024 "low risk" cases, and may serve as reference to assess outcome of single or any groups of patients. OBJECTIVE: To propose benchmark outcome values in liver transplantation, serving as reference for assessing individual patients or any other patient groups. BACKGROUND: Best achievable results in liver transplantation, that is, benchmarks, are unknown. Consequently, outcome comparisons within or across centers over time remain speculative. METHODS: Out of 7492 liver transplantation performed in 17 international centers from 3 continents, we identified 2024 low risk adult cases with a laboratory model for end-stage liver disease score ≤20 points, a balance of risk score ≤9, and receiving a primary graft by donation after brain death. We chose clinically relevant endpoints covering intra- and postoperative course, with a focus on complications graded by severity including the complication comprehensive index (CCI). Respective benchmarks were derived from the median value in each center, and the 75 percentile was considered the benchmark cutoff. RESULTS: Benchmark cases represented 8% to 49% of cases per center. One-year patient-survival was 91.6% with 3.5% retransplantations. Eighty-two percent of patients developed at least 1 complication during 1-year follow-up. Biliary complications occurred in ...