Abstract:
:We sought to examine the relationship between liver transplant-related total cost, patient outcome, and hospital resource utilization at freestanding children's hospitals. Using the PHIS database, a retrospective study of 374 patients that underwent liver transplantation at 15 freestanding children's hospitals from July 2010 to December 2012 was performed. One-year graft failure and patient mortality rates from July 2010 to December 2012 for each center were also obtained from the SRTR. There was a 5.1-fold difference in median cost (median $146 444, range $59 487-302 058, P<.001) between all centers. A 2.4-fold difference existed in median LOS (median 15 days, range 9-22 days, P<.001) across centers. Median postoperative ICU stay varied from 0 to 7 days (median 4 days, P<.001). Overall, 30-day readmission rate was 55% (31.3%-100%, P<.001). One-year graft failure varied from 0% to 19.1%, with an overall rate of 5.5% (P=.279). One-year patient mortality for all centers was 2.3% (range 0%-11.1%, P=.016). Higher total cost did not correlate with lower readmission rates, patient mortality, graft failure, or any other variable. These data suggest that identifying practice patterns at low-cost centers and implementing them at higher-cost centers may decrease the cost of pediatric liver transplantation without compromising outcomes.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Minneman JA,Grijalva JL,LaQuaglia MJ,Kim HB,Rangel SJ,Vakili Kdoi
10.1111/petr.12783subject
Has Abstractpub_date
2016-11-01 00:00:00pages
921-925issue
7eissn
1397-3142issn
1399-3046journal_volume
20pub_type
杂志文章abstract:OBJECTIVES:To study the characteristics and the predictors of survival observed in our pediatric live-donor renal transplant recipients with an allograft that functioned for more than 10 yr. METHODS:One hundred fifteen children underwent renal transplantation between 1976 and 1995. Of these, 30 had functioning allogra...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00455.x
更新日期:2006-05-01 00:00:00
abstract::To analyze the clinical profile and outcome of pediatric patients who had undergone a liver and/or RT at our center over a five yr period, case records of all the patients who had undergone a liver or RT were analyzed retrospectively. One hundred solid organ transplants were performed at our center between January 200...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12324
更新日期:2014-11-01 00:00:00
abstract::Although TEG directs effective resuscitation in adult surgical patients, pediatric data are lacking. We performed a retrospective comparative review of the effect of TEG on blood product utilization and outcomes following pediatric liver transplantation in 38 patients between 2008 and 2014. Diagnoses, laboratory value...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13176
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND AIM:The aim of the study was to assess efficacy and safety of endoscopic treatment in BS after pediatric LTx. METHODS:We retrospectively reviewed data of patients with DDA who developed BS and underwent ERCP. RESULTS:Of 189 transplanted patients with DDA, strictures developed in 30 (16%). In this subgr...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13271
更新日期:2018-11-01 00:00:00
abstract::Cardiac transplantation for children with end-stage cardiac disease with no other medical or surgical options is now standard. The number of children in need of cardiac transplant continues to exceed the number of donors considered "acceptable." Therefore, there is an urgent need to understand which recipients are in ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.13671
更新日期:2020-05-01 00:00:00
abstract:: We present an 18-yr-old adolescent with acute lymphocytic leukemia, who underwent peripheral blood SCT with serologically and histologically documented chronic hepatitis B infection. Prior and during the transplant process, lamivudine was administered orally and he underwent SCT with a twofold decrease in viral load...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2009.01272.x
更新日期:2011-08-01 00:00:00
abstract::Thrombosis after kidney transplantation may result in catastrophic outcomes, including graft loss. Thrombophilia has been implicated in post-transplant thrombosis; data, however, are inconclusive on the impact of acquired and inherited thrombophilia and resultant thrombosis in renal graft recipients. We aimed to evalu...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13314
更新日期:2019-02-01 00:00:00
abstract::HCV infection is the leading cause of liver transplantation in the adult population in the United States. HCV infection occurs in 0.2-0.4% of the pediatric population and progression to HCC is uncommon. Liver transplantation for HCV in children is rare. In this report, we present a case of pediatric patient with HCV a...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12223
更新日期:2014-03-01 00:00:00
abstract::This review details the indications for heart transplantation in children. Contraindications have evolved from absolute to relative. Controversial issues remain and this paper represents a consensus of more than a dozen centers that have programs that remain active performing pediatric heart transplants. ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.1999.00045.x
更新日期:1999-11-01 00:00:00
abstract::Primary hyperoxalurias are rare inborn errors of metabolism with deficiency of hepatic enzymes that lead to excessive urinary oxalate excretion and overproduction of oxalate which is deposited in various organs. Hyperoxaluria results in serious morbid-ity, end stage kidney disease (ESKD), and mortality if left untreat...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13313
更新日期:2019-02-01 00:00:00
abstract::Improving a patient's quality-of-life (QOL) post-liver transplantation is of great importance. An aspect of improved QOL is the restoration of normal growth patterns in pediatric patients. To describe the post-transplantation growth patterns of 72 children included in the National Institute of Diabetes and Digestive a...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00326.x
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:The hybrid stage 1 palliation for hypoplastic left heart syndrome (HLHS) was first described in 1993 as a bridge to heart transplant for HLHS. There are limited data on this strategy as primary heart transplantation for HLHS has become less common. METHODS:This is an observational, single-center study compa...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13307
更新日期:2018-12-01 00:00:00
abstract::Non-adherence to immunosuppressant medications is an important risk factor for graft dysfunction. To evaluate the effectiveness of adherence-enhancing interventions, we reviewed adherence intervention studies in solid organ transplant recipients (all ages). Using the following databases: PsycINFO, PubMed, Scopus, and ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.13086
更新日期:2018-02-01 00:00:00
abstract::Parents of pediatric liver and kidney transplant recipients were surveyed regarding their current education plans (eg, Individualized Education Program, 504), satisfaction with these plans, and interest in educational support from the psychosocial transplant team. Survey results indicate high rates of IEP and 504 plan...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13412
更新日期:2019-06-01 00:00:00
abstract::In order to assess certain aspects of pediatric kidney transplantation (Tx) in Turkey, we retrospectively analyzed the results of 56 of these pediatric procedures performed at our center. From January 1986 to January 1998, 56 pediatric renal Tx (29 males, 27 females; 0-17 yr of age) were carried out at Başkent Univers...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2000.00130.x
更新日期:2000-11-01 00:00:00
abstract::A major risk faced by bone-marrow and solid organ transplant patients is the development of post-transplant lymphoproliferative disease or post-transplant lymphoma (PTLD). In pediatric transplantation, PTLD onset is often associated with a rapid rise in Epstein-Barr virus (EBV) load in peripheral blood mononuclear cel...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2003.00090.x
更新日期:2003-08-01 00:00:00
abstract::The outcomes of pediatric ventricular assist device support in patients with diastolic heart failure have not been well described. This study reviews the North American experience with Berlin Heart EXCOR® ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was review...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13048
更新日期:2017-12-01 00:00:00
abstract::Although the majority of pediatric solid organ transplant centers in the United States employ psychosocial criteria to assess the suitability of potential transplant candidates, there are no standardized pretransplant psychosocial assessment measures. Assessment scales that have been developed were designed for adult ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00785.x
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The use of ventricular assist devices (VADs) in children with heart failure may be of particular benefit to those with accompanying renal failure, as improved renal function is seen in some, but not all recipients. We hypothesized that persistent renal dysfunction at 7 days and/or 1 month after VAD implantat...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13477
更新日期:2019-08-01 00:00:00
abstract::RTx of adult-size kidneys presents a size mismatch in small pediatric recipients, and there are potential surgical complications. This study reveals the outcomes of intra- and extraperitoneal RTx in low-weight (less than 15 kg) pediatric recipients. We studied 51 pediatric patients weighing less than 15 kg who receive...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13401
更新日期:2019-06-01 00:00:00
abstract::Tailoring graft size to small paediatric recipients is a challenge. We have developed a reduced left lateral segment as an alternative to monosegment transplantation for small size recipients. Since November 2000, 89 children have been transplanted with 100 deceased donor liver grafts in our unit. Our median patient a...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00882.x
更新日期:2008-09-01 00:00:00
abstract::Psychomotor development in pediatric liver transplant (LT) recipients depends on several factors. Our aim was to evaluate the importance of parental involvement and family dynamics on psychomotor development by assessing (i) children and parents individually, (ii) the parent-child relationship, and (iii) the correlati...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12080
更新日期:2013-06-01 00:00:00
abstract::A 4-year-old boy presented 14 months after liver and small bowel transplantation with fever, diarrhea, elevated liver enzymes, thrombocytopenia and autoantibodies. Total gammaglobulins level was normal but the level of plasma IgA1 was very high. The blood PCR for Epstein-Barr virus (EBV) was negative. The ileal biopsy...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2004.00174.x
更新日期:2004-06-01 00:00:00
abstract::For infants with SCID, the ideal conditioning regimen before allogeneic HCT would omit cytotoxic chemotherapy to minimize short- and long-term complications. We performed a prospective pilot trial with G-CSF plus plerixafor given to the host to mobilize HSC from their niches. We enrolled six patients who received CD34...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12309
更新日期:2014-09-01 00:00:00
abstract::Few studies have identified the psychosocial characteristics of those children and their families associated with future non-adherence to immunosuppressive medications following a heart or lung transplant. UNOS data and medical records information were used to test the association between patient and family psychosoci...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12899
更新日期:2017-06-01 00:00:00
abstract::Sirolimus represents a major advancement in the field of solid organ transplantation and is being used as a rescue agent for acute and chronic rejection as well as for primary immunosuppression with good graft outcome. Although initial studies with sirolimus were in adults, now significant data have accumulated on the...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00305.x
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Studies of HRQoL after kidney transplant have yielded conflicting results. We sought to assess the impact of kidney transplant on HRQoL. METHODS:We performed a retrospective study using the PedsQL3.0ESRD module during dialysis and at 3 and 12 months following kidney transplant in 56 recipients. For the enti...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13333
更新日期:2019-03-01 00:00:00
abstract::PPCA has historically been considered detrimental to donor quality in LT, but transplantation of grafts from this group of donors is now routine. Our study aims to evaluate the outcomes associated with use of donors with a history of PPCA in the pediatric population. This study is a single-center retrospective analysi...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13701
更新日期:2020-08-01 00:00:00
abstract::Early graft loss and poor graft function limit the use of kidneys from infant donors. Six en bloc kidney transplantations were performed from infant donors younger than 10 months into pediatric recipients between November 2012 and September 2015 at our center. We retrospectively analyzed recipient and donor demographi...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12845
更新日期:2017-03-01 00:00:00
abstract::Children who undergo heart transplantation are at risk for long-term neurodevelopmental sequelae secondary to heart disease and its treatment. Detailed neuropsychological profiles in clinical sample status post-pediatric heart transplantation are sparse in the literature, and there is little information regarding pred...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13615
更新日期:2020-02-01 00:00:00