Textbook Outcome Following Liver Transplantation
Chétana Lim, Laura Lladó, Chady Salloum, Emilio Ramos, Josefina López-Domínguez, Alba Cachero, Joan Fabregat, Daniel Azoulay
Abstract
BACKGROUND: Textbook outcome (TBO) is a patient-oriented composite criterion achieved when all desired main health outcomes are realized. The aim was to assess the incidence and the independent factors associated with TBO following LT. METHODS: This bicentric study included all patients who underwent their first elective liver-only LT between 2011 and 2015. TBO occurred when all the following criteria were fulfilled: no mortality within 90 days, no major complications within 90 days, no reintervention within 90 days (liver graft biopsy, radiological, endoscopic or surgical interventions, or retransplantation), no prolonged intensive care unit stay, and no prolonged hospital stay. Univariable and multivariable analyses were performed to identify factors associated with TBO and to assess whether TBO is an independent factor associated with patient and graft survival. RESULTS: The study population included 530 patients. TBO occurred in 176/530 (33%) patients. Independent factors associated with TBO included the balance of risk score, the use of an intraoperative temporary portacaval shunt, and duration of the operation. TBO was identified as an independent factor associated with graft survival but not patient survival. CONCLUSIONS: TBO might be implemented in the patient-doctor decision-making regarding whether to proceed with LT and in the reporting of patient-level hospital performance related to LT.