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Accurately measuring and critically reviewing outcomes data are the first steps in continuous quality improvement. Our liver transplant team is committed to not only reviewing, but sharing our outcomes with patients, families and the transplant community. We believe this philosophy helps create an open, collaborative environment in which sharing of knowledge and best practices will improve the care for all children undergoing liver transplantation.
U.S. News & World Report consistently ranks the Division of Gastroenterology at Cincinnati Children’s among the nation’s top programs in its annual guide of “Best Children’s Hospitals.”
Integral to the gastroenterology program is the Liver Transplant Program. To achieve the best outcomes, we have assembled dedicated teams that track a variety of measures, each aimed at improving care before and after liver transplantation. Measures we currently report include:
On this page you can learn more about our performance and how we are working to “Change the Outcome” for patients and their families. The statistics are from the Scientific Registry of Transplant Recipients (SRTR), a national database.
Note: “United States / National” data are for illustration only. Based on the unique mix of patients served by a transplant program, and the large difference in numbers between patients transplanted or on the wait list at an individual program and ALL patients transplanted or on the wait list across the country, the numbers and rates may not be directly comparable.
Patient survival represents the patients who are alive at a given time after transplant (30 days, one year and three years). Because each transplant center serves patients with varying levels of complexity, the SRTR takes into account a number of factors when calculating the “expected” survival rate for an individual center. This calculation is called “risk adjustment” and accounts for specific patient and donor characteristics such as the age and weight of the donor, the type of liver graft (whole or partial) and the presence of complications of end-stage liver disease in the transplant recipient.
Graft survival represents the patients who are alive with a functioning liver transplant at a given time after transplant (30 days, one year and three years). As with patient survival, the SRTR risk adjusts for expected graft survival. This helps account for center-to-center differences and complexity in patient populations and allows for better comparisons of performance on key outcomes among transplant centers.
According to previous program-specific SRTR reports for the time period between 1/1/2008 and 06/30/2010, the percentage of patients who died on the waiting list (without liver transplant) has ranged from 2.3% to 8.7%. From 7/1/2012 to 6/30/2013, no patients awaiting primary liver transplant died on the waiting list.
Mortality on the waiting list is defined as the percentage of patients on a transplant center’s waiting list who die over a given period of time (six months, 12 months, 18 months) after being placed on the list.
According to previous program-specific SRTR reports for the time period between 7/1/2004 and 12/31/2012, the median months on the waitlist before transplant has ranged from 3.6 to 4.0 months.
The median is the middle value in a series of numbers arranged in order from lowest to highest. Half of these numbers are higher than the median and half are lower. The median wait time for a liver transplant is a good reflection of actual patient experience as it is less likely to be affected by very short wait times (for example, one day) or very long wait times (for example, four years).
One of the novel areas in which the program at Cincinnati Children’s excels is transplantation for pediatric liver tumors*. Since 2007, we have performed more transplants for pediatric liver tumors than any other program in North America (28 liver transplants from January 2007 to May 2013)**.
*Includes hepatoblastoma, hepatoma, hepatocellular carcinoma and other specific liver tumors; does not include hemangioendothelioma
**Source: Organ Procurement and Transplantation Network (OPTN) data as of May 2013
Our results for post-transplant patient and graft survival for children with liver tumors have been excellent. We believe our ability to achieve these outcomes is based on our comprehensive and multidisciplinary approach to management of pediatric liver tumors. This approach includes close collaboration among a variety of specialists and includes: Pediatric Oncology, Pediatric Surgery, Pediatric Transplant Hepatology, Pediatric Pathology and Pediatric Radiology.
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