Dataset Information

Arthroplasty in organ transplant patients.

ABSTRACT: The number of solid organ transplants performed in the United States continues to increase annually as does survival after transplant. These unique patients are increasingly likely to present to arthroplasty surgeons for elective hip or knee replacement secondary to a vascular necrosis from chronic immunosuppression, or even age-related development of osteoarthritis. Transplant recipients have a well-documented increased risk of complications but also excellent pain relief and dramatic improvement in quality of life. A multidisciplinary approach with the assistance of the medical transplant services for risk stratification and perioperative medical optimization is necessary. Prior solid organ transplant is not a contraindication to surgery; however, it is the responsibility of the surgeon to educate patients about the relative risks and benefits of prior to surgery.

SUBMITTER: Nickel BT

PROVIDER: S-EPMC4926828 | biostudies-other | 2015 Jun

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Arthroplasty in organ transplant patients.

Nickel Brian T BT Ledford Cameron K CK Watters Tyler Steven TS Wellman Samuel S SS Bolognesi Michael P MP

Arthroplasty today 20150619 2

The number of solid organ transplants performed in the United States continues to increase annually as does survival after transplant. These unique patients are increasingly likely to present to arthroplasty surgeons for elective hip or knee replacement secondary to a vascular necrosis from chronic immunosuppression, or even age-related development of osteoarthritis. Transplant recipients have a well-documented increased risk of complications but also excellent pain relief and dramatic improveme ...[more]

PMID: 28326368

Similar Datasets

Project description:ImportanceUnder the current Centers for Medicare & Medicaid Services guidelines, there is incentivization to optimize posttransplant outcomes regardless of mortality among patients on the waitlist and transplant rates; few data exist with regard to transplant center acceptance practices and survival to heart transplant.ObjectivesTo evaluate the extent of variability in organ acceptance practices in the US and whether this center-level behavior is associated with heart transplant candidate survival.Design, setting, and participantsIn this retrospective cohort study, the US National Transplant Registry was queried for all match runs of adult candidates listed for isolated heart transplant between May 1, 2007, and March 31, 2017. Data analysis was conducted from October 30, 2018, to May 1, 2019. The final cohort included 93 transplant centers, 19 703 donors, and 9628 candidates.Main outcomes and measuresCenter acceptance rates for heart allografts offered to the highest-priority candidates, association between center acceptance rate and mortality among patients on the waitlist, and posttransplant outcomes between candidates who accepted their first-rank offers vs those who accepted previously declined offers.ResultsAmong 19 703 unique organ offers, 6302 hearts (32.0%) were accepted for first-rank candidates. After adjustment for donor, candidate, and geographic covariates, transplant centers varied in acceptance rates (12.3%-61.5%) of offers made to first-rank candidates. Higher acceptance rates were associated with lower cumulative incidence of 1-year mortality among patients on the waitlist. For every 10% increase in adjusted center acceptance rate, the risk of mortality decreased by 27% (subdistribution hazard ratio, 0.73; 95% CI, 0.67-0.80). No statistically significant difference was observed in 5-year adjusted posttransplant patient survival (adjusted hazard ratio, 1.02; 95% CI, 0.94-1.11) and graft failure (subdistribution hazard ratio; 0.95; 95% CI, 0.83-1.09) between hearts accepted at the first-rank compared with lower-rank positions.Conclusions and relevanceVariability in heart allograft acceptance rates appears to exist among transplant centers, with candidates listed at lower acceptance rate centers being more likely to experience mortality while on the waitlist. Comparable posttransplant survival suggests that allografts that were declined as a first offer perform as well as those that were accepted at their first offer. These findings suggest that organ acceptance rate or time to transplant from being added to the waitlist may be an additional measure of heart transplant program performance.

Dataset Information

Arthroplasty in organ transplant patients.

Publications

Arthroplasty in organ transplant patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets