Impact of Anesthesiologist Experience on Early Outcomes in Adult Orthotopic Liver Transplantation

Transplant Proc. 2021 Jun;53(5):1665-1669. doi: 10.1016/j.transproceed.2021.04.004. Epub 2021 May 18.

Abstract

Background: Liver transplantation is a complex surgical procedure. The experience of the anesthesiologist, and its potential relationship to patient morbidity and mortality, is yet to be determined. We sought to explore this possible association using our institutional training patterns as the subject of study.

Methods: This is a single center retrospective analysis investigating the association of an anesthesiologist's experience with liver transplantation and its potential effect on early patient outcomes in adult liver transplant recipients from January 2010 to September 2016. Training of team members consisted of a 6-month period of clinical shadowing with a senior anesthesiologist and co-staffing 8 liver transplant procedures before solo staffing a liver transplant. Specifically, patient outcomes for the first 5 transplants after this training were investigated.

Results: The only independent risk factor for early death or early graft loss was the amount of packed red blood cells administered during transplantation. With respect to secondary outcomes, the amount of packed red blood cells and hospitalization at the time of transplant were associated with the number of days on a ventilator, length of intensive care unit stay, and overall hospital length of stay.

Conclusions: The results of this study conclude that the training model currently in place for our new team members has no negative impact on patient outcomes after liver transplantation.

MeSH terms

  • Anesthesiologists / statistics & numerical data*
  • End Stage Liver Disease / surgery*
  • Erythrocyte Transfusion
  • Female
  • Graft Rejection / mortality
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Odds Ratio
  • Retrospective Studies
  • Treatment Outcome
  • Ventilators, Mechanical