Impact of nighttime and weekend liver transplants on graft and patient outcomes§

Authors

  • Eric S. Orman,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC
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  • Paul H. Hayashi,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC
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  • Evan S. Dellon,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC
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  • David A. Gerber,

    1. Division of Abdominal Transplant, Department of Surgery, University of North Carolina, Chapel Hill, NC
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  • A. Sidney Barritt IV

    Corresponding author
    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC
    • IV, M.D., M.S.C.R., Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Campus Box 7584, Chapel Hill, NC 27599-7584
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    • Telephone: 919-966-2516; FAX: 919-966-1700;


  • Eric S. Orman contributed to the study concept and design, the acquisition of data, the drafting of the manuscript, and the critical revision of the manuscript. Paul H. Hayashi contributed to the interpretation and analysis of data and the critical revision of the manuscript. Evan S. Dellon contributed to the study concept and design, the statistical analysis, the interpretation and analysis of data, and the critical revision of the manuscript. David A. Gerber contributed to the interpretation and analysis of data and the critical revision of the manuscript. A. Sidney Barritt IV contributed to the study concept and design, the statistical analysis, the interpretation and analysis of data, the drafting of the manuscript, and the critical revision of the manuscript.

  • This work was supported in part by the National Institutes of Health (grant 1KL2-RR025746-03 to A. Sidney Barritt IV and grant T32 DK07634 to Eric S. Orman).

  • §

    This work was supported in part by the Health Resources and Services Administration (contract 231-00-0115). The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

Abstract

Safety concerns have been raised about nighttime and weekend patient care, but it is unknown whether these issues affect liver transplantation. We sought to identify the impact of nighttime and weekend liver transplants on graft and patient survival. We used the United Network for Organ Sharing database to review adult liver transplants from 1987 to 2010. Comparisons were made between nighttime and daytime operations and between weekday and weekend operations. Cox proportional hazard ratios (HRs) were determined 30, 90, and 365 days after transplantation after we controlled for relevant factors; 94,768 transplants were included in the analysis. The patient survival rates at 30, 90, and 365 days for nighttime operations were 96%, 93%, and 86%, respectively. The patient survival rates at 30, 90, and 365 days for weekend operations were 95%, 92%, and 86%, respectively. These rates did not significantly differ from those for daytime and weekday operations, respectively. The graft failure rate was unchanged at 30 and 90 days for weekend transplants but was modestly increased at 365 days [HR = 1.05 (95% confidence interval = 1.01-1.11)]. Graft survival was unaffected by nighttime transplantation. Nighttime and weekend operations for liver transplantation do not affect patient or graft survival, and this testifies to the patient safety measures in place. Liver Transpl, 2012. © 2012 AASLD.

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