Abstract:
:Recent changes in Center for Medicare & Medicaid Services (CMS) condition for participation, using benchmark volume/outcomes requirements for certification, have been implemented. Consequently, the ability of a transplant center to assess its risk tolerance is important in successful management. An analysis of SRTR data was performed to determine donor/recipient risk factors for graft loss or patient death in the first year. Each transplant performed was then assigned a prospective relative risk (RR) of failure. Using a Monte-Carlo simulation, transplants were selected at random that met the centers' acceptable risk tolerance. Transplant center volume was fixed and its risk tolerance was adjusted to determine the impact on outcomes. The model was run 1000 times on centers with varying volume. The modeling demonstrates that centers with smaller annual volumes must use a more risk taking strategy than larger volume centers to avoid being flagged for CMS volume requirements. The modeling also demonstrates optimal risk taking strategies for centers based upon volume to minimize the probability of being flagged for not meeting volume or outcomes benchmarks. Small volume centers must perform higher risk transplants to meet current CMS requirements and are at risk for adverse action secondary to chance alone.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Johnson SR,Karp SJ,Curry MP,Barugel M,Rodrigue JR,Mandelbrot DA,Rogers CP,Hanto DWdoi
10.1111/j.1399-0012.2012.01658.xsubject
Has Abstractpub_date
2012-05-01 00:00:00pages
E269-76issue
3eissn
0902-0063issn
1399-0012journal_volume
26pub_type
杂志文章abstract:BACKGROUND:Incisional hernias, that significantly affect the quality of life of patients, are common complications especially after major surgery, such as liver transplantation. The purpose of this meta-analysis is to outline the available evidence on the complications occurring after mesh implantation as a treatment o...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.14103
更新日期:2020-12-01 00:00:00
abstract::The evaluation and care of non-US citizen, non-US residents who wish to come to the United States to serve as international living kidney donors (ILKDs) can pose unique challenges. We surveyed US transplant programs to better understand practices related to ILKD care. We distributed the survey by email and professiona...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14064
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:To assess the diagnostic value of magnetic resonance cholangiography (MRC) when evaluating biliary complications in a large series of liver transplants. METHODS:One hundred and twenty-nine patients prospectively underwent magnetic resonance (MR) imaging and MR cholangiography at 1.5-T device after orthotopi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01190.x
更新日期:2010-07-01 00:00:00
abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:The role of advanced age live donors remains controversial because of decline in glomerular filtration rate and perceived increased risks of perioperative complications. METHODS:A retrospective review of all live donor transplants performed from January 2000 to December 2003. RESULTS:Seventy-eight live don...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00328.x
更新日期:2005-10-01 00:00:00
abstract::Post-transplant lymphoproliferative disorder (PTLD) may compromise long-term outcome of lung transplant (LTx) recipients. A case-control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post-transplant outcomes were assessed. ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12983
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate the characteristics of lung transplant recipients requiring additional pleural drainage catheters early post-lung transplantation and to determine the safety and efficacy of intrapleural fibrinolytics in these patients. METHODS:A retrospective review of lung transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13592
更新日期:2019-06-01 00:00:00
abstract::Liver transplantation for hepatitis B virus (HBV)-related liver disease has changed from a contraindication to outcomes comparable with non-HBV-related liver transplantations during the last two decades. Mainly the implementation of immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and the use of nucleoside ana...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2006.00609.x
更新日期:2006-01-01 00:00:00
abstract::This study evaluated the efficacy of primary endovascular stenting in cases of transplant renal artery stenosis (TRAS) from cadaver and non-heart-beating donor kidneys. Patients with TRAS (n = 13) from a single-centre transplant population (n = 476) were treated by primary percutaneous angioplasty and endovascular ste...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00499.x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described. METHODS:Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were includ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12168
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:Smoking is a major public health issue, and its effect on cardiovascular outcomes is well established. This study evaluates the impact of donor smoking on heart transplant (HT) outcomes. METHODS:HT recipients between January 1, 2005, and December 31, 2016, with known donor smoking status were queried from the ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14127
更新日期:2020-10-23 00:00:00
abstract:BACKGROUND:Angiotensin converting enzyme (ACE) inhibitors have been successfully used for treatment of proteinuria after renal transplantation (RTx). Factors possibly responsible for the great inter-patient variance of the antiproteinuric effect (APE) have not yet been investigated in renal-transplanted patients. METH...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:To analyze the characteristics of tuberculosis (TB) in Southern Chinese renal transplant recipients, and summarize the corresponding experiences in diagnosis and management. METHOD:Retrospectively study 41 documented post-transplant TB cases out of the 2333 patients who received kidney transplantation in th...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00878.x
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:Autologous islet transplantation (IAT) following pancreatectomy is now a recognized, albeit highly specialized procedure carried out in a small number of centers worldwide. Current clinical principles and best practice with emphasis on examining the technical aspects of surgery in centers with significant IA...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析,评审
doi:10.1111/ctr.12695
更新日期:2016-04-01 00:00:00
abstract::We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busul...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12061
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:End-stage renal disease is associated with illness-induced disruptions that challenge patients and their families to accommodate and adapt. However, the impact of patients' marital status on kidney transplant outcome has never been studied. This project, based on data from United States Renal Data System (US...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00575.x
更新日期:2007-01-01 00:00:00
abstract::Tacrolimus (TAC) is a calcineurin inhibitor that is used for cardiac allograft rejection. Efficacy and safety data of a combined TAC/mycophenolate mofetil (MMF) therapy in comparison with a TAC/cortisone therapy in heart recipients are lacking. We analysed the clinical outcome of 41 patients who received TAC in combin...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00504.x
更新日期:2006-07-01 00:00:00
abstract::Renal transplantation offers patients with end-stage renal disease the best opportunity for rehabilitation and long-term survival. However, there is a critical shortage of transplantable kidneys worldwide. This plays well into the hands of transplanters and entrepreneurs involved in commercial renal transplantation, p...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::The shortage of kidney donors has led to broadening of the acceptance criteria for deceased donor organs beyond the traditional use of young donors. We determined long-term post-transplant outcomes in recipients of dual expanded criteria donor kidneys (dECD, n = 44) and compared them to recipients of standard criteria...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00956.x
更新日期:2009-06-01 00:00:00
abstract::We examined histological features of allograft biopsies in ABO minor-mismatched kidney transplantation. Forty-five patients who underwent ABO minor-mismatched kidney transplantation between September 1999 and December 2001 at our institute. The mean age was 32.6 years, with 28 males and 17 females. We divided them int...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.17.s10.1.x
更新日期:2003-01-01 00:00:00
abstract::Diabetic transplant recipients are at a high risk for foot pathology leading to amputation. This retrospective study from 1/85 to 2/95 examines the risk of foot complications in a population (n = 340) of diabetic renal and combined renal/pancreas transplant recipients. All groups suffered high lower extremity amputati...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract::The aim of this study was to assess the independent association between pre-transplant prescription opioid use and readmission following liver transplantation. We reviewed the medical records of all patients at a single medical center undergoing primary, single-organ, liver transplantation from 2004 to 2014. We assess...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12806
更新日期:2016-10-01 00:00:00
abstract::Porto-pulmonary hypertension with moderate or severe pulmonary arterial hypertension (PAH) is viewed as a contraindication to liver transplantation (LT) because of associated poor outcomes; however, patients with biliary atresia (BA) are generally good candidates for LT. Ten patients with moderate/severe PAH underwent...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12415
更新日期:2014-09-01 00:00:00
abstract::Acute renal failure (ARF) is a common and severe complication after liver transplantation (LT). The aim of this study was to ascertain the impact of ARF requiring dialysis in the outcome of LT and to analyze the risk factors leading to this event in the early post-operative period. From October 1988 to December 1994, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:The Southeastern Kidney Transplant Coalition was created in 2010 to improve kidney transplant (KTx) rates in Georgia, North Carolina, and South Carolina. To identify dialysis staff-reported barriers to transplant, the Coalition developed a survey of dialysis providers in the region. METHODS:All dialysis uni...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12693
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD). PATIENTS AND METHODS:One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12666
更新日期:2016-02-01 00:00:00
abstract::To assess the prevalence and long-term impact of HCV on kidney transplant recipients, we assayed 716 pre-transplant sera using a first-generation ELISA. The anti-HCV positive sera were confirmed by a 6-antigen radioimmunoassay (RIA). Patients were followed up for 5 years. Graft survival, function, evidence of chemical...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs c...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/ctr.13225
更新日期:2018-04-01 00:00:00
abstract::15-deoxyspergualin (DSG) is a novel immunosuppressant which has been shown to be effective in preventing and treating rejection in animal allo- and xenotransplant models. Preliminary clinical studies suggest that DSG is an effective antirejection agent. In our study, 4 patients with biopsy-proven rejection episodes th...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Mycobacterium tuberculosis (TB) is a common pathogen worldwide, and it may cause significant infection after solid organ transplantation (SOT). We reviewed all reported TB cases to provide an update on its epidemiology, clinical presentation, management, and outcome after SOT. METHODS:MEDLINE, EMBASE, and O...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13259
更新日期:2018-06-01 00:00:00