Outcomes and Resource Utilization in Liver Transplant Recipients Who Underwent Expedited Transplant Evaluation

Background Expedited liver transplant evaluations of critically ill patients can be challenging due to limited time for data gathering and psychosocial evaluation. Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpati...

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Published in:Progress in transplantation (Aliso Viejo, Calif.) Calif.), 2023-09, Vol.33 (3), p.223-228
Main Authors: Lin, Emily, Patel, Anish, Young, Ericka, Gao, Yinglin, Peng, Jiahao, Woloszyn, Jakub, Volk, Michael L, Rakoski, Mina O.
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container_start_page 223
container_title Progress in transplantation (Aliso Viejo, Calif.)
container_volume 33
creator Lin, Emily
Patel, Anish
Young, Ericka
Gao, Yinglin
Peng, Jiahao
Woloszyn, Jakub
Volk, Michael L
Rakoski, Mina O.
description Background Expedited liver transplant evaluations of critically ill patients can be challenging due to limited time for data gathering and psychosocial evaluation. Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups. Design Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing
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Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups. Design Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing &lt;2 weeks. Primary outcomes included rates of graft rejection, graft failure, and death within 1-year posttransplant. Secondary outcomes included number of acute care visits, office visits, and medical record documentation made by transplant staff within 1-year posttransplant. Outcomes were compared using Cox regression models. Results Of the 335 patients included, 92 (27.5%) were expedited and 243 (72.5%) were traditional. Expedited patients were significantly younger, had greater MELD scores, and required more inpatient care and life support at time of transplant. There was no significant difference in risk of graft rejection (HR 1.3, P = .4), graft failure (HR 1.3, P = .6), or mortality (HR 1.0, P = .9) between groups. Expedited transplant was not associated with increased healthcare or staff utilization: acute care visits (rate ratio 0.9, P = .7), office visits (β = −1.05, P = .2), and medical record documentation (β = 3.4, P = 0.4). Conclusions Despite being more critically ill, patients requiring expedited transplant evaluation have favorable outcomes after transplant and do not require more intensive staff time and resources compared to traditional candidates.</description><identifier>ISSN: 1526-9248</identifier><identifier>EISSN: 2164-6708</identifier><identifier>DOI: 10.1177/15269248231189870</identifier><identifier>PMID: 37501560</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><ispartof>Progress in transplantation (Aliso Viejo, Calif.), 2023-09, Vol.33 (3), p.223-228</ispartof><rights>2023, NATCO. 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Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups. Design Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing &lt;2 weeks. Primary outcomes included rates of graft rejection, graft failure, and death within 1-year posttransplant. Secondary outcomes included number of acute care visits, office visits, and medical record documentation made by transplant staff within 1-year posttransplant. Outcomes were compared using Cox regression models. Results Of the 335 patients included, 92 (27.5%) were expedited and 243 (72.5%) were traditional. Expedited patients were significantly younger, had greater MELD scores, and required more inpatient care and life support at time of transplant. There was no significant difference in risk of graft rejection (HR 1.3, P = .4), graft failure (HR 1.3, P = .6), or mortality (HR 1.0, P = .9) between groups. Expedited transplant was not associated with increased healthcare or staff utilization: acute care visits (rate ratio 0.9, P = .7), office visits (β = −1.05, P = .2), and medical record documentation (β = 3.4, P = 0.4). 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Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups. Design Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing &lt;2 weeks. Primary outcomes included rates of graft rejection, graft failure, and death within 1-year posttransplant. Secondary outcomes included number of acute care visits, office visits, and medical record documentation made by transplant staff within 1-year posttransplant. Outcomes were compared using Cox regression models. Results Of the 335 patients included, 92 (27.5%) were expedited and 243 (72.5%) were traditional. Expedited patients were significantly younger, had greater MELD scores, and required more inpatient care and life support at time of transplant. There was no significant difference in risk of graft rejection (HR 1.3, P = .4), graft failure (HR 1.3, P = .6), or mortality (HR 1.0, P = .9) between groups. Expedited transplant was not associated with increased healthcare or staff utilization: acute care visits (rate ratio 0.9, P = .7), office visits (β = −1.05, P = .2), and medical record documentation (β = 3.4, P = 0.4). Conclusions Despite being more critically ill, patients requiring expedited transplant evaluation have favorable outcomes after transplant and do not require more intensive staff time and resources compared to traditional candidates.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37501560</pmid><doi>10.1177/15269248231189870</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-5326-2886</orcidid></addata></record>
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title Outcomes and Resource Utilization in Liver Transplant Recipients Who Underwent Expedited Transplant Evaluation
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