Patterns and outcomes associated with patient migration for liver transplantation in the United States

Kristopher P. Croome, David D. Lee, Justin M. Burns, Dana K. Perry, Andrew P. Keaveny, C. Burcin Taner

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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.

Original languageEnglish (US)
Article numbere0140295
JournalPloS one
Issue number10
StatePublished - Oct 15 2015

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General


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