Journal ArticleHeliyon · September 15, 2024
BACKGROUND: All patients starting dialysis should be informed of kidney transplant as a renal replacement therapy option. Prior research has shown disparities in provision of this information. In this study, we aimed to identify patient sociodemographic an ...
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Journal ArticleHepatology · September 1, 2024
The liver transplantation (LT) evaluation and waitlisting process is subject to variations in care that can impede quality. The American Association for the Study of Liver Diseases (AASLD) Practice Metrics Committee (PMC) developed quality measures and pat ...
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ConferenceAm J Transplant · August 2024
In the United States, potential transplant candidates with insulin-dependent diabetes mellitus are inconsistently offered pancreas transplantation (PTx), contributing to a dramatic decline in pancreas allograft utilization over the past 2 decades. The Amer ...
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Journal ArticleHepatol Commun · May 1, 2024
Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The cur ...
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Journal ArticleKidney360 · January 1, 2024
KEY POINTS: Incidence of ESKD in the first year after primary organ transplant ranges from 2.4% to 3.6% and from 1.4% to 1.8% in the second year post-transplant. National data sources do not currently collect sufficiently reliable follow-up data to identif ...
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Journal ArticleTransplant Proc · 2024
BACKGROUND: Interventions to improve racial equity in access to living donor kidney transplants (LDKT) have focused primarily on patients, ignoring the contributions of clinicians, transplant centers, and health system factors. Obtaining access to LDKT is ...
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ConferenceTransplant Proc · December 2023
Black individuals are less likely to receive live donor kidney transplantation (LDKT) compared to others. This may be partly related to their concerns about LDKT, which can vary based on age and gender. We conducted a cross-sectional, secondary analysis of ...
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Journal ArticleJAMA Netw Open · December 1, 2023
IMPORTANCE: It is unclear whether center-level factors are associated with racial equity in living donor kidney transplant (LDKT). OBJECTIVE: To evaluate center-level factors and racial equity in LDKT during an 11-year time period. DESIGN, SETTING, AND PAR ...
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Journal ArticleJAMA Netw Open · December 1, 2023
IMPORTANCE: Studies elucidating determinants of residential neighborhood-level health inequities are needed. OBJECTIVE: To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hyp ...
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Journal ArticleAnn Surg Open · December 2023
OBJECTIVE: This study aims to introduce key concepts and methods that inform the design of studies that seek to quantify the causal effect of social determinants of health (SDOH) on access to and outcomes following organ transplant. BACKGROUND: The causal ...
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Journal ArticleLiver Transpl · November 1, 2023
Disparities exist in referral and access to the liver transplant (LT) waitlist, and social determinants of health (SDOH) are increasingly recognized as important factors driving health inequities, including in LT. The SDOH of potential transplant candidate ...
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Journal ArticleLiver Transpl · November 1, 2023
Standard eligibility criteria for simultaneous liver-kidney transplantation (SLK) are in place in the United States. We hypothesize that the benefit associated with SLK over liver transplant alone differs by patient, depending on the specific SLK criteria ...
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Journal ArticleAm J Surg · October 2023
Attrition is high among surgical trainees, and six of ten trainees consider leaving their programs, with two ultimately leaving before completion of training. Given known historically and systemically rooted biases, Black surgical trainees are at high risk ...
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Journal ArticleAm J Transplant · September 2023
We aimed to identify variations in liver transplant access across transplant referral regions (TRRs), accounting for differences in population characteristics and practice environments. Adult end-stage liver disease (ESLD) deaths and liver waitlist additio ...
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Journal ArticleCurrent Transplantation Reports · September 1, 2023
Purpose of Review: To summarize contemporary evidence describing the most appropriate candidates for simultaneous heart kidney transplantation (SHK), estimates of how SHK affects the entire transplantation system and implications of recently enacted SHK al ...
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Journal ArticleCurr Opin Organ Transplant · August 1, 2023
PURPOSE OF REVIEW: As policies governing liver transplantation (LT) continue to change and influence clinical practice, it is important to monitor trends in equitable access and outcomes amongst patients. The purpose of this review is to closely examine re ...
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Journal ArticleAm J Transplant · March 2023
The choice of deprivation index can influence conclusions drawn regarding the extent of deprivation within a community and the identification of the most deprived communities in the United States. This study aimed to determine the degree of correlation amo ...
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Journal ArticleHepatol Commun · March 1, 2023
BACKGROUND: Employment outcomes after liver transplant (LT) over the past decade have not been described. METHODS: LT recipients ages 18-65 from 2010-2018 were identified in Organ Procurement and Transplantation Network data. Employment within two years po ...
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Journal ArticlePediatr Transplant · February 2023
BACKGROUND: Shortages of liver allografts for children awaiting transplantation have led to high LT waitlist mortality. Prior studies have shown that usage of TVG can reduce waiting time and waitlist mortality, but their use is not universal. We sought to ...
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Journal ArticleTransplant Proc · 2023
BACKGROUND: To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansion on payor mix among patients on the kidney and liver transplant waiting list as well as waiting list and post-transplant outcomes. DESIGN: Using the Scientific Registry o ...
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Journal ArticleFront Public Health · 2023
Among the causes of inequity in organ transplantation, geography is oft-cited but rarely defined with precision. Traditionally, geographic inequity has been characterized by variation in distance to transplant centers, availability of deceased organ donors ...
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Journal ArticleJ Card Surg · November 2022
BACKGROUND: Heart failure affects >6 million people in the United States alone and is most prevalent in Black patients who suffer the highest mortality risk. Yet prior studies have suggested that Black patients are less likely to receive advanced heart fai ...
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Journal ArticleAm J Transplant · October 2022
Health equity research in transplantation has largely relied on national data sources, yet the availability of social determinants of health (SDOH) data varies widely among these sources. We sought to characterize the extent to which national data sources ...
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Journal ArticleProg Transplant · September 2022
Introduction: Knowledge about living donor kidney transplant (LDKT) is associated with greater access. Yet, little is known about factors associated with high living donor transplant knowledge. Research Questions: Is receipt of LDKT information from health ...
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Journal ArticleKidney Med · September 2022
RATIONALE & OBJECTIVE: Choosing from multiple kidney failure treatment modalities can create decisional conflict, but little is known about this experience before decision implementation. We explored decisional conflict about treatment for kidney failure a ...
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Journal ArticleJAMA Netw Open · September 1, 2022
IMPORTANCE: System and center-level interventions to improve health equity in organ transplantation benefit from robust characterization of the referral population served by each transplant center. Transplant referral regions (TRRs) define geographic catch ...
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Journal ArticleBJS Open · May 2, 2022
BACKGROUND: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. METHODS: CHOLECOVID is an international, multicentre, observational comparative study of patients ad ...
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Journal ArticleClin Transplant · May 2022
UNLABELLED: There are no established regulations governing patient selection for simultaneous heart-kidney (SHK) transplantation, creating the potential for significant center-level variations in clinical practice. METHODS: Using the United Network for Org ...
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Journal ArticleClin Transplant · April 2022
The growth in pancreas transplant is driven in part by expansion of indications to include an increasing number of select patients with type 2 diabetes. Two papers in this month's issue of Clinical transplantation specifically investigate this association, ...
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Journal ArticleInternational journal for equity in health · February 2022
BackgroundOrgan transplant is the preferred treatment for end-stage organ disease, yet the majority of patients with end-stage organ disease are never placed on the transplant waiting list. Limited access to the transplant waiting list combined wi ...
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Journal ArticleKidney360 · January 27, 2022
Participants who identified as female and Black reported more thorough discussions of dialysis than transplant.Participants with low incomes and education reported more thorough discussions of dialysis than transplant. ...
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Journal ArticleHPB (Oxford) · December 2021
BACKGROUND: Liver transplantation is definitive therapy for end stage liver disease in pediatric patients. Living donor liver transplantation (LDLT) with the left lateral segment (LLS) is often a feasible option. However, the size of LLS is an important fa ...
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Journal ArticleJ Clin Med · November 24, 2021
The impact of HLA matching on graft survival has been well characterized in renal transplantation, with a higher degree of matching associated with superior graft survival. Additionally, living donor grafts are known to confer superior survival compared to ...
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Journal ArticleAdv Chronic Kidney Dis · November 2021
Stark racial disparities in access to and receipt of kidney transplantation, especially living donor and pre-emptive transplantation, have persisted despite decades of investigation and intervention. The causes of these disparities are complex, are inter-r ...
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Journal ArticleTransplant Direct · September 2021
BACKGROUND: Livers from "nonideal" but acceptable donors are underutilized; however, organ procurement organization (OPO) metrics do not assess how OPO-specific practices contribute to these trends. In this analysis, we evaluated nonideal liver donor avoid ...
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Journal ArticleNephrol Ther · August 2021
BACKGROUND: The first wave of the Covid-19 pandemic resulted in a drastic reduction in kidney transplantation and a profound change in transplant care in France. It is critical for kidney transplant centers to understand the behaviors, concerns and wishes ...
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Journal ArticleLiver Transpl · August 2021
Historically in the United States, kidneys for simultaneous liver-kidney transplantation (SLKT) candidates were allocated with livers, prioritizing SLKT recipients over much of the kidney waiting list. A 2017 change in policy delineated renal function crit ...
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Journal ArticleAm J Transplant · July 2021
The incidence of simultaneous heart-kidney transplant (SHK) has increased markedly in the last 15Â years. There are no universally agreed upon indications for SHK vs. heart alone (HA) transplant, and center evaluation processes vary widely. We utilized Scie ...
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Journal ArticleAm J Transplant · June 2021
Lack of donors hinders living donor kidney transplantation (LDKT) for African Americans. We studied the effectiveness of a transplant social worker intervention (TALK SWI) alone or paired with living donor financial assistance to activate African Americans ...
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Journal ArticleAm J Transplant · June 2021
Despite extraordinary achievements in over the past 20Â years, the field of transplantation remains hindered by relatively narrow metrics for success. Eudaimonia is an Aristotelian concept that refers to flourishing, or achieving the best conditions possibl ...
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Journal ArticleWorld J Surg · May 2021
BACKGROUND: "Textbook outcome" (TO) is a novel composite quality measure that encompasses multiple postoperative endpoints, representing the ideal "textbook" hospitalization for complex surgical procedures. We defined TO for kidney transplantation using a ...
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Journal ArticleClin Transplant · April 2021
BACKGROUND: Although discussions with family or friends can improve access to living-donor kidney transplantation (LDKT), they remain an understudied step in the LDKT process. METHODS: Among 300 African American transplant candidates, we examined how socio ...
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Journal ArticleLiver Transpl · February 2021
Liver grafts from pediatric donors represent a small fraction of grafts transplanted into adult recipients, and their use in adults requires special consideration of donor size to prevent perioperative complications. In the past, graft weight or volume rat ...
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Journal ArticleTransplant Direct · January 2021
BACKGROUND: Midodrine is often needed pretransplant to improve hemodynamics in simultaneous liver-kidney transplant candidates. Previous research has shown that patients requiring midodrine before kidney transplant alone have increased posttransplant risk ...
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Journal ArticleCancers (Basel) · November 14, 2020
Liver transplantation (LT) remains a mainstay of treatment for hepatocellular carcinoma (HCC). Tumor factors such as size and number of tumors define eligibility for LT using the Milan criteria. The tumor burden score (TBS) incorporates both tumor number a ...
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Journal ArticleAm J Transplant · November 2020
The authors comment on the usefulness of a new model to advise centers on risks versus benefits of kidney transplantation during the COVID epidemic. See page 2997 for Massie et al's article. ...
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Journal ArticleAm J Surg · November 2020
BACKGROUND: The Kidney Allocation System (KAS) was developed to improve equity and utility in organ allocation. We examine the effect of this change on kidney graft distribution and survival. METHODS: UNOS data was used to identify first-time adult recipie ...
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Journal ArticleWorld J Surg · October 2020
BACKGROUND: Textbook outcome (TO) is an emerging concept within multiple surgical domains, which represents a novel effort to define a standardized, composite quality benchmark based on multiple postoperative endpoints that represent the ideal "textbook" h ...
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Journal ArticleAnn Surg · September 1, 2020
OBJECTIVE: We sought to compare kidney transplantation outcomes between Veterans Affairs (VA) and non-VA transplant centers. SUMMARY BACKGROUND DATA: Transplant care at the VA has previously been scrutinized due to geographic and systematic barriers. The r ...
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Journal ArticleClin Transplant · February 2020
Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The pur ...
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Journal ArticleTransplantation · February 2020
BACKGROUND: The morbidity and mortality from alcohol-related liver disease (ALD) is increasing in the United States. However, little is known about gender differences in evaluation and listing for liver transplantation (LT) in patients with ALD. METHODS: T ...
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Journal ArticleIn Vivo · 2020
BACKGROUND: Outcomes after kidney transplantation (KTx) remain limited by delayed graft function (DGF) and acute rejection. Non-invasive biomarkers may help identify patients at increased risk for these events. We examined the association between the syste ...
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Journal ArticleAm J Transplant · July 2019
The imbalance between supply and demand of organs for transplant will not be fully solved by changes to the allocation system. Improved organ donation and utilization must be accomplished through critical reassessment of organ procurement organization (OPO ...
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Journal ArticleAm J Med Qual · 2017
The purpose of this study was to use fault tree analysis to evaluate the adequacy of quality reporting programs in identifying root causes of postoperative bloodstream infection (BSI). A systematic review of the literature was used to construct a fault tre ...
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Journal ArticleWMJ · June 2016
Successful liver transplantation typically results in an immediate decrease in intrahepatic resistance accompanied by an initial increased hepatopedal portal flow. Within a short period of time, the portal hypertension resolves and the variceal shunts invo ...
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Journal ArticleBMJ Qual Saf · May 2016
BACKGROUND: Failure mode and effects analysis (FMEA) is a method of risk assessment increasingly used in healthcare over the past decade. The traditional method, however, can require substantial time and training resources. The goal of this study is to com ...
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Journal ArticleInt J Qual Health Care · April 2016
OBJECTIVE: Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test t ...
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Journal ArticleTransplantation · April 2016
Over the past 5 years, early hospital readmissions have become a national focus. With several recent publications highlighting the high rates of early hospital readmissions among transplant recipients, more work is needed to identify risk factors and strat ...
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Journal ArticleBMJ Qual Saf · January 2016
BACKGROUND: Video recorded and in-person observations are methods of quality assessment and monitoring that have been employed in high risk industries. In the medical field, observations have been used to evaluate the quality and safety of various clinical ...
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Journal ArticleJ Am Geriatr Soc · December 2015
Kidney transplantation is a good option for adults aged 65 and older with end-stage renal disease because it has been shown to reduce morbidity and mortality, improve quality of life, and is more cost-effective than other renal replacement options. However ...
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Journal ArticleAm J Surg · October 2015
BACKGROUND: Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm. METHODS: Interviews were conducted with clinicians involved ...
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ConferenceSurgery · September 2015
BACKGROUND: The goal of this study was to assess systems and processes involved in the operating room (OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. METHODS: We performed a failure mo ...
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Journal ArticleTransplantation · August 2015
BACKGROUND: Research on posttransplant care has predominantly focused on predictors of readmission with little attention to emergency department (ED) visits. The goal of this study was to describe early postoperative ED care of transplant recipients. METHO ...
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Journal ArticleInt J Med Inform · February 2015
OBJECTIVE: Urgent clinician-clinician communications require routes of contact that are fast and dependable, and allow for the exchange of complex information. Despite the increasing focus on improving healthcare delivery systems over the past decade, few ...
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Journal ArticleJ Surg Res · January 2015
Wrong-site surgery (WSS) is a rare event that occurs to hundreds of patients each year. Despite national implementation of the Universal Protocol over the past decade, development of effective interventions remains a challenge. We performed a systematic re ...
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Journal ArticleSurgery · November 2014
BACKGROUND: Rates of medical errors and adverse events remain high for patients who undergo kidney transplantation; they are particularly vulnerable because of the complexity of their disease and the kidney transplantation procedure. Although institutional ...
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Journal ArticleAm J Surg · October 2014
BACKGROUND: Liver transplantation is a complex surgery associated with high rates of postoperative complications. While national outcomes data are available, national rates of most complications are unknown. DATA SOURCES: A systematic review of the literat ...
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Journal ArticleClin J Am Soc Nephrol · August 7, 2014
BACKGROUND AND OBJECTIVES: The Statewide Sharing variance to the national kidney allocation policy allocates kidneys not used within the procuring donor service area (DSA), first within the state, before the kidneys are offered regionally and nationally. T ...
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Journal ArticleTransplantation · May 27, 2014
BACKGROUND: Waiting time to deceased donor kidney transplant varies greatly across the United States. This variation violates the final rule, a federal mandate, which demands geographic equity in organ allocation for transplantation. METHODS: Retrospective ...
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Journal ArticleTranspl Infect Dis · April 2014
Infections remain a common complication of solid organ transplantation. Early postoperative infections remain a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Although significant effort has been made to understand ...
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Journal ArticleHPB (Oxford) · January 2014
OBJECTIVES: This study was conducted to determine if routine staging chest computed tomography (CT) or positron emission tomography (PET) scanning alters the clinical management of patients with newly diagnosed pancreatic adenocarcinoma. METHODS: All new p ...
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Journal ArticleBMJ Qual Saf · December 2013
Incomplete, fragmented and poorly organised communications contribute to more than half the errors that lead to adverse and sentinel events. Meanwhile, communication software and devices with expanding capabilities are rapidly proliferating and being intro ...
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Journal ArticleWMJ · June 2013
BACKGROUND: Pedestrian-vehicle crashes are a significant problem in public health. Understanding contributing factors within a specific community helps recognize and target key intervention points. METHODS: Trauma registry analysis included all of the pati ...
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Journal ArticleNutr Clin Pract · December 2012
BACKGROUND: The practice of holding enteral nutrition (EN) 8 hours prior to surgery is common. We hypothesized that it was safe to continue postpyloric EN, and we developed an institutional practice pattern to investigate our hypothesis. METHODS: Our pilot ...
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Journal ArticleAm J Hosp Palliat Care · 2008
This study investigated training in pain management in postgraduate medical education programs. A mail survey of program directors was conducted, evaluating the format of training in pain management and the self-assessed adequacy of the training. The respo ...
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