This study was supported by K23-DK085204 from the National Institute of Diabetes and Digestive and Kidney Diseases and a Research Scholar Award from the American Gastroenterological Association (MLV). The sponsors had no role in design, conduct, or interpretation of the study, or approval of the manuscript.
Variation in Organ Quality between Liver Transplant Centers
Version of Record online: 5 APR 2011
©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 11, Issue 5, pages 958–964, May 2011
How to Cite
Volk, M. L., Reichert, H. A., Lok, A. S. F. and Hayward, R. A. (2011), Variation in Organ Quality between Liver Transplant Centers. American Journal of Transplantation, 11: 958–964. doi: 10.1111/j.1600-6143.2011.03487.x
This study utilized the Measurement Core of the Michigan Diabetes Research and Training Center (NIDDK of The National Institutes of Health [P60 DK-20572]). The data reported here have been supplied by the Arbor Research Collaborative for Health (Arbor Research) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the U.S. Government.
- Issue online: 26 APR 2011
- Version of Record online: 5 APR 2011
- Received 08 June 2010, revised 09 November 2010 and accepted for publication 15 November 2010
- Center effect;
- donor/recipient matching;
- liver transplantation;
A wide spectrum of quality exists among deceased donor organs available for liver transplantation. It is unknown whether some transplant centers systematically use more low quality organs, and what factors might influence these decisions. We used hierarchical regression to measure variation in donor risk index (DRI) in the United States by region, organ procurement organization (OPO) and transplant center. The sample included all adults who underwent deceased donor liver transplantation between January 12, 2005 and February 1, 2009 (n = 23 810). Despite adjusting for the geographic region and OPO, transplant centers’ mean DRI ranged from 1.27 to 1.74, and could not be explained by differences in patient populations such as disease severity. Larger volume centers and those having competing centers within their OPO were more likely to use higher risk organs, particularly among recipients with lower model for end-stage liver disease (MELD) scores. Centers using higher risk organs had equivalent waiting list mortality rates, but tended to have higher post-transplant mortality (hazard ratio 1.10 per 0.1 increase in mean DRI). In conclusion, the quality of deceased donor organ patients receive is variable and depends in part on the characteristics of the transplant center they visit.