RESUMO
Given the complexity of solid organ transplantation, it is reasonable to believe that numerous factors are at play in achieving the enviable outcomes reported. The aim of this study is to examine the role of an organizational structure in maintaining the outcomes of a multiorgan transplant program at a nonacademic center. A retrospective analysis of 2378 solid organ transplants at Nazih Zuhdi Transplant Institute between March 1985 and December 2008 was performed. The 1-year and 3-year patient and graft survival rates, rate of retransplantation, and median length of hospital stay were compared with US national data released by the Scientific Registry of Transplant Recipients in January 2009. The 1-year patient survival rates were 87.5% for heart, 95.1% for kidney, 75.8% for lung, 89.6% for liver, and 100.0% for pancreas. The 3-year patient survival rates were 73.5% for heart, 89.7% for kidney, 57.8% for lung, 87.7% for liver, and 100.0% for pancreas. A well-structured transplant program along with competent medical, administrative, and ancillary support can achieve comparable patient and graft survival rates independent of volume.
Assuntos
Hospitais Religiosos/organização & administração , Transplante de Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Sobrevivência de Enxerto , Humanos , Tempo de Internação/estatística & dados numéricos , Modelos Organizacionais , Oklahoma/epidemiologia , Transplante de Órgãos/mortalidade , Avaliação de Resultados em Cuidados de Saúde , Equipe de Assistência ao Paciente/organização & administração , Avaliação de Programas e Projetos de Saúde , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Taxa de Sobrevida , Gestão da Qualidade Total/organização & administraçãoRESUMO
Transjugular intrahepatic portosystemic shunt (TIPS) is a useful procedure for preventing complications of portal hypertension. Nutritional effects of TIPS have been described in cirrhotics. In this prospective study, the nutritional effects of TIPS in cirrhotics were aimed to be identified. BMI, anthropometric measurements, laboratory parameters and Chronic liverdisease quality of life score were measured at baseline, three and six moths following TIPS placement. Total of 12 patients (6 male, 6 female; mean age 56 years; range 41-80) were enrolled between March 2002 and June 2004. Mean baseline MELD score was 13. Only 6 out of 12 patients were able to complete the study due to several reasons. BMI increased from 21.4 to 25.5. Estimated muscle mass improved from 16.6 to 20.5 (p < 0.05). Mean serum albumin improved from 2.46 to 2.76. CLDQL score improved from 103 to 150 (p < 0.05). This small study suggests potential nutritional benefits of TIPS.