Heart and Lung Transplantation in the United States, 1996–2005

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74833/1/j.1600-6143.2007.01783.x.pd

Heart and Lung Transplantation in the United States, 1997–2006

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73552/1/j.1600-6143.2008.02175.x.pd

Composite Scores for Transplant Center Evaluation: A New Individualized Empirical Null Method

Risk-adjusted quality measures are used to evaluate healthcare providers while controlling for factors beyond their control. Existing healthcare provider profiling approaches typically assume that the risk adjustment is perfect and the between-provider variation in quality measures is entirely due to the quality of care. However, in practice, even with very good models for risk adjustment, some between-provider variation will be due to incomplete risk adjustment, which should be recognized in assessing and monitoring providers. Otherwise, conventional methods disproportionately identify larger providers as outliers, even though their provider effects need not be "extreme.'' Motivated by efforts to evaluate the quality of care provided by transplant centers, we develop a composite evaluation score based on a novel individualized empirical null method, which robustly accounts for overdispersion due to unobserved risk factors, models the marginal variance of standardized scores as a function of the effective center size, and only requires the use of publicly-available center-level statistics. The evaluations of United States kidney transplant centers based on the proposed composite score are substantially different from those based on conventional methods. Simulations show that the proposed empirical null approach more accurately classifies centers in terms of quality of care, compared to existing methods

Influence of Graft Type on Outcomes After Pediatric Liver Transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74904/1/j.1600-6143.2004.00359.x.pd

Analytical approaches for transplant research

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73605/1/j.1600-6135.2004.00402.x.pd

Patient Selection and Volume in the Era Surrounding Implementation of Medicare Conditions of Participation for Transplant Programs

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110882/1/hesr12188.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/110882/2/hesr12188-sup-0001-AuthorMatrix.pd

Liver regeneration after living donor transplantation: Adult‐to‐adult living donor liver transplantation cohort study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109827/1/lt23966.pd

SRTR Center‐Specific Reporting Tools: Posttransplant Outcomes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106770/1/j.1600-6143.2006.01275.x.pd

Hepatocellular Carcinoma Recurrence and Death Following Living and Deceased Donor Liver Transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75606/1/j.1600-6143.2007.01802.x.pd

Liver transplant recipient survival benefit with living donation in the model for endstage liver disease allocation era

Receipt of a living donor liver transplant (LDLT) has been associated with improved survival compared with waiting for a deceased donor liver transplant (DDLT). However, the survival benefit of liver transplant has been questioned for candidates with Model for Endstage Liver Disease (MELD) scores <15, and the survival advantage of LDLT has not been demonstrated during the MELD allocation era, especially for low MELD patients. Transplant candidates enrolled in the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study after February 28, 2002 were followed for a median of 4.6 years. Starting at the time of presentation of the first potential living donor, mortality for LDLT recipients was compared to mortality for patients who remained on the waiting list or received DDLT (no LDLT group) according to categories of MELD score (<15 or ≥15) and diagnosis of hepatocellular carcinoma (HCC). Of 868 potential LDLT recipients (453 with MELD <15; 415 with MELD ≥15 at entry), 712 underwent transplantation (406 LDLT; 306 DDLT), 83 died without transplant, and 73 were alive without transplant at last follow‐up. Overall, LDLT recipients had 56% lower mortality (hazard ratio [HR] = 0.44, 95% confidence interval [CI] 0.32‐0.60; P < 0.0001). Among candidates without HCC, mortality benefit was seen both with MELD <15 (HR = 0.39; P = 0.0003) and MELD ≥15 (HR = 0.42; P = 0.0006). Among candidates with HCC, a benefit of LDLT was not seen for MELD <15 (HR = 0.82, P = 0.65) but was seen for MELD ≥15 (HR = 0.29, P = 0.043). Conclusion: Across the range of MELD scores, patients without HCC derived a significant survival benefit when undergoing LDLT rather than waiting for DDLT in the MELD liver allocation era. Low MELD candidates with HCC may not benefit from LDLT. (H EPATOLOGY 2011;54:1313–1321)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86878/1/24494_ftp.pd