PLoS ONE
Volume 10, Issue 10, 2015

Patterns and outcomes associated with patient migration for liver transplantation in the United States (Article) (Open Access)

Croome K.P. , Lee D.D. , Burns J.M. , Perry D.K. , Keaveny A.P. , Taner C.B.
  • a Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
  • b Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
  • c Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
  • d Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
  • e Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
  • f Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States

Abstract

Background: Traveling to seek specialized care such as liver transplantation (LT) is a reality in the UnitedStates. Patient migration has been attributed to organ availability. The aims of this study were to delineate patterns of patient migration and outcomes after LT. Study Design: All deceased donor LT between 2008-2013 were extracted from UNOS data. Migratedpatients were defined as those patients who underwent LT at a center in a different UNOS region from the region in which they resided and traveled a distance > 100 miles. Results: Migrated patients comprised 8.2% of 28,700 LT performed. Efflux and influx of patientswere observed in all 11 UNOS regions. Regions 1, 5, 6, and 9 had a net efflux, while regions 2, 3, 4, 7, 10, and 11 had a net influx of patients. After multivariate adjustment for donor andrecipient factors, graft (p = 0.68) and patient survival (p = 0.52) were similar between migrated and non-migrated patients. Conclusion: A significant number of patients migrated in patterns that could not be explained alone byregional variations in MELD score and wait time. Migration may be a complex interplay of factors including referral patterns, specialized services at centers of excellence and patientpreference. © 2015 Croome et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

Tissue Donors donor human middle aged travel statistics and numerical data overall survival Liver Diseases Tissue and Organ Procurement United States transplantation Humans study design Treatment Outcome graft survival male female patient referral liver transplantation clinical article organization and management adult Model For End Stage Liver Disease Score
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84949034870&doi=10.1371%2fjournal.pone.0140295&partnerID=40&md5=f53f96737ec405a65f38dd8bb68abfa2
DOI: 10.1371/journal.pone.0140295
ISSN: 19326203
Cited by: 6
Original Language: English