TY - JOUR
T1 - Patterns and outcomes associated with patient migration for liver transplantation in the United States
AU - Croome, Kristopher P.
AU - Lee, David D.
AU - Burns, Justin M.
AU - Perry, Dana K.
AU - Keaveny, Andrew P.
AU - Taner, C. Burcin
N1 - Publisher Copyright:
© 2015 Croome et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2015/10/15
Y1 - 2015/10/15
N2 - Background: Traveling to seek specialized care such as liver transplantation (LT) is a reality in the UnitedStates. Patient migration has been attributed to organ availability. The aims of this study were to delineate patterns of patient migration and outcomes after LT. Study Design: All deceased donor LT between 2008-2013 were extracted from UNOS data. Migratedpatients were defined as those patients who underwent LT at a center in a different UNOS region from the region in which they resided and traveled a distance > 100 miles. Results: Migrated patients comprised 8.2% of 28,700 LT performed. Efflux and influx of patientswere observed in all 11 UNOS regions. Regions 1, 5, 6, and 9 had a net efflux, while regions 2, 3, 4, 7, 10, and 11 had a net influx of patients. After multivariate adjustment for donor andrecipient factors, graft (p = 0.68) and patient survival (p = 0.52) were similar between migrated and non-migrated patients. Conclusion: A significant number of patients migrated in patterns that could not be explained alone byregional variations in MELD score and wait time. Migration may be a complex interplay of factors including referral patterns, specialized services at centers of excellence and patientpreference.
AB - Background: Traveling to seek specialized care such as liver transplantation (LT) is a reality in the UnitedStates. Patient migration has been attributed to organ availability. The aims of this study were to delineate patterns of patient migration and outcomes after LT. Study Design: All deceased donor LT between 2008-2013 were extracted from UNOS data. Migratedpatients were defined as those patients who underwent LT at a center in a different UNOS region from the region in which they resided and traveled a distance > 100 miles. Results: Migrated patients comprised 8.2% of 28,700 LT performed. Efflux and influx of patientswere observed in all 11 UNOS regions. Regions 1, 5, 6, and 9 had a net efflux, while regions 2, 3, 4, 7, 10, and 11 had a net influx of patients. After multivariate adjustment for donor andrecipient factors, graft (p = 0.68) and patient survival (p = 0.52) were similar between migrated and non-migrated patients. Conclusion: A significant number of patients migrated in patterns that could not be explained alone byregional variations in MELD score and wait time. Migration may be a complex interplay of factors including referral patterns, specialized services at centers of excellence and patientpreference.
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U2 - 10.1371/journal.pone.0140295
DO - 10.1371/journal.pone.0140295
M3 - Article
C2 - 26469071
AN - SCOPUS:84949034870
SN - 1932-6203
VL - 10
JO - PloS one
JF - PloS one
IS - 10
M1 - e0140295
ER -