Heart transplant outcomes better at high-volume centers

Older or sicker patients seeking new hearts were more likely to be alive a year later if they had their surgeries performed at high-volume heart transplant centers, according to new research from Johns Hopkins University.

Hospitals that performed more than 15 transplants per year were designated as high-volume centers, while low-volume facilities performed six transplants or less annually. High-risk patients transplanted at low-volume centers had a 67 percent increased risk of death after one year compared with high-risk patients transplanted at high-volume centers, the study's authors determined.

The findings, which were presented Monday at the American Association of Thoracic Surgeons' annual meeting in Philadelphia, show "growing evidence throughout medicine and surgery that the volume of cases done at a given medical center has an impact on outcomes," George J. Arnaoutakis, MD, a general surgery resident at the Johns Hopkins University School of Medicine and the study's leader, said in a statement.

Arnaoutakis warned, though, that the findings should not be seen as a knock on the skill of surgeons at low-volume centers; the systems and infrastructure of a such a center would likely be relevant to the findings.

For the study, the researchers examined data from the United Network of Organ Sharing (UNOS) of all of the heart transplants performed in the U.S. between January 2000 and December 2009. Each of the 17,211 patients examined had a risk score that took into account known risk factors for complications and/or death after a heart transplant, including age, race, cause of heart failure, bilirubin and creatinine levels and whether they had been on life support.

For more information:
- read this HealthDay News article
- see the Johns Hopkins release

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