Kidney's Nightshift, Kidney's Nightmare? Comparison of Daylight and Nighttime Kidney Transplantation: Impact on Complications and Graft Survival

Fechner, G.; Pezold, Carolin Von; Hauser, Stefan; Gerhardt, Thomas; Müller, Stefan

doi:10.1016/j.transproceed.2008.02.072

Cited by 81 publications

(86 citation statements)

References 14 publications

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“…At least some centers have adopted this strategy in light of single center data suggesting worse outcomes are associated with nighttime recipient operations (13,14). For liver transplantation, however, the adverse impact of prolonging cold ischemia is well established, and the window of acceptable CIT is decidedly narrower, to the extent that delaying a recipient operation in favor of a daytime operation could render some grafts unusable (15 Lonze et al …”

Section: The Field Of Transplantation Is Unique Among the Surgical Sumentioning

confidence: 99%

Operative Start Times and Complications After Liver Transplantation

Lonze

Parsikia²,

Feyssa

et al. 2010

American Journal of Transplantation

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The recent national focus on patient safety has led to a re-examination of the risks and benefits of nighttime surgery. In liver transplantation, the hypothetical risks of nighttime operation must be weighed against either the well-established risks of prolonging cold ischemia or the potential risks of strategies to manipulate operative start times. A retrospective review was conducted of 578 liver transplants performed at a single institution between 1995 and 2008 to determine whether the incidence of postoperative complications correlated with operative start times. We hypothesized that no correlation would be observed between complication rates and operative start times. No consistent trends in relative risk of postoperative wound, vascular, biliary, or other complications were observed when eight 3-h time strata were compared. When two 12-h time strata (night, 3 p.m.-3 a.m., and day, 3 a.m.-3 p.m.) were compared, complications were not significantly different, but nighttime operations were longer in duration, and were associated a twofold greater risk of early death compared to daytime operations (adjusted OR 2.9, 95% CI 1.16-7.00, p = 0.023), though long-term survival did not differ significantly between the subgroups. This observation warrants further evaluation and underscores the need to explore and identify institution-specific practices that ensure safe operations regardless of time of day.

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Section: The Field Of Transplantation Is Unique Among the Surgical Sumentioning

confidence: 99%

Operative Start Times and Complications After Liver Transplantation

Lonze

Parsikia²,

Feyssa

et al. 2010

American Journal of Transplantation

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“…Convenience factors or a desire to avoid complicated cases may also play a role since hospitals that have the capacity to treat a patient may refer the patient if there is suspicion that the case would negatively impact hospital rankings or patient satisfaction or increase complication rates. For example, at night, fewer personnel are present at the hospital, and patients experience longer delays in treatment [4][5][6] . Increased rates of complications and deaths associated with surgical procedures performed at night or during out-of-office hours may explain why there are higher transfer rates at night 3,7 .…”

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confidence: 99%

The Characteristics of Referring Facilities and Transferred Hand Surgery Patients

Kuo

Hartzell

Eberlin

et al. 2014

Journal of Bone and Joint Surgery

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“…This emphasizes the necessity to perform a DDRT at any time of the day and night in order to keep the CIT as short as possible. Although some authors have stated that ‘off hours' renal transplantation poses a higher risk on graft outcome, this hypothesis could not be confirmed in a multivariate analysis [25]. The rate of DGF was significantly higher in the study group (45.9 vs. 30.3%, p = 0.004).…”

Section: Discussionmentioning

confidence: 82%

Fate of Finally Transplanted Deceased Donor Kidneys Initially Rejected at Other Kidney Transplantation Centers

Friedersdorff¹,

Roller²,

Manus³

et al. 2014

Urol Int

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Objective: We conducted this study to determine whether it is justifiable for transplant centers to reject cadaveric donor organs based on marginal organ quality. There is a growing discrepancy between the demand for renal transplants and the number of transplants conducted. For the many patients on the renal transplant waiting list, this translates into increased dialysis-associated morbidity, mortality and a reduced quality of life. Patients and Methods: In our retrospective analysis, we focused on deceased donor kidneys that had been rejected in other transplant centers because of poor organ quality (111 patients) and then accepted for transplantation at our center, compared with a control group consisting of 343 patients. Results: Cold ischemia time was statistically significantly shorter in the control group (11 vs. 12.5 h, p = 0.005). Also, delayed graft function occurred significantly (p = 0.004) more often in the study group (45.9-30.3%). Parameters regarding perioperative data and recipient outcome did not show significant differences and except for 2 time points at 1 week and 3 months, graft function did not differ either. Conclusions: We propose that acceptance criteria for marginal donor kidneys should be expanded. Centers should reconsider their acceptance criteria in the light of these findings as the results of these transplantations may even be much better if the delay due to reallocation and retransport can be spared.

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Kidney's Nightshift, Kidney's Nightmare? Comparison of Daylight and Nighttime Kidney Transplantation: Impact on Complications and Graft Survival

Cited by 81 publications

References 14 publications

Operative Start Times and Complications After Liver Transplantation

Operative Start Times and Complications After Liver Transplantation

The Characteristics of Referring Facilities and Transferred Hand Surgery Patients

Fate of Finally Transplanted Deceased Donor Kidneys Initially Rejected at Other Kidney Transplantation Centers

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