AATS: High-Volume Transplant Centers Tied to Lower Mortality

Mortality improved in high-risk recipients who undergo heart surgery at high-volume centers

TUESDAY, May 10 (HealthDay News) -- High-risk patients who undergo heart transplantation at a low-volume center have a higher mortality rate than those who undergo transplantation at a high-volume center, according to research presented at the annual meeting of the American Association of Thoracic Surgeons, held from May 7 to 11 in Philadelphia.

George J. Arnaoutakis, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated data on 17,211 patients who underwent heart transplantation in the United States between January 2000 and December 2009 and assigned each patient a risk score. The investigators also categorized the 141 hospitals where the transplants took place as low-, medium-, or high-volume centers.

Compared to high-risk patients transplanted at high-volume centers, the investigators found that high-risk patients transplanted at low-volume centers had a 67 percent increased risk of death one year post-surgery. Among high-risk recipients, one-year mortality was 84 percent at high-volume centers, 82 percent at medium-volume centers, and 78 percent at low-volume centers. However, this difference diminished among low-risk recipients.

"There are certain processes that may be better performed at regional centers of excellence doing more of a certain procedure," Arnaoutakis said in a statement. "People talk about it with airline pilots -- only at 10,000 hours of flying are they considered expert at flying. The experience of a center can be discussed in similar terms."

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