General Surgery and Organ Transplantation Unit, Department of General Surgery and Surgical Specialties, Sapienza University of Rome, AOU Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy.
Department of Surgery Science, University of Rome Tor Vergata, U.O.C. Chirurgia Epatobiliare e Trapianti, Fondazione PTV, Rome, Italy.
Updates Surg. 2023 Apr;75(3):531-539. doi: 10.1007/s13304-022-01348-9. Epub 2022 Aug 10.
Poor data exist on the influence of holidays and weekdays on the number and the results of liver transplantation (LT) in Italy. The study's main objective is to investigate the impact of holidays and the different days of the week on the LT number and early graft survival rates in a multi-centric Italian series. We performed a retrospective analysis on 1,026 adult patients undergoing first deceased-donor transplantation between January 2004 and December 2018 in the three university centers in Rome. During the 4,504 workdays, 881 LTs were performed (85.9%; one every 5.1 days on average). On the opposite, 145 LTs were done during the 975 holidays (14.1%; one every 7.1 days on average). Fewer LTs were performed on holidays (P = 0.004). There were no substantial differences in donor-, recipient- and transplant-related characteristics in LTs performed on weekdays or holidays. On Monday, fewer transplants were performed (vs. other weekdays: P < 0.0001; vs. Sunday: P = 0.03). At multivariable Cox regression analysis, LTs performed during the holiday or during the different days of the week were not found to be independent risk factors for the risk of 3- and 12-month graft loss. At three-month survival curves, no differences were observed among the transplants performed during the holidays versus the workdays (86.2 vs. 85.0%; P-0.70). The range of graft survival rates based on the day of the week was 81.6-86.9%, without showing any significant differences (P = 0.57). Fewer transplants are performed on holidays and Mondays. Survivals are not affected by holidays or the day the transplant is performed.
意大利有关节假日和星期几对肝移植（LT）数量和结果影响的数据有限。本研究的主要目的是在多中心意大利系列中研究节假日和不同星期几对 LT 数量和早期移植物存活率的影响。我们对 2004 年 1 月至 2018 年 12 月期间在罗马的三个大学中心接受首次尸源移植的 1026 例成年患者进行了回顾性分析。在 4504 个工作日中，进行了 881 例 LT（平均每 5.1 天进行一次）。相反，在 975 个节假日中进行了 145 例 LT（平均每 7.1 天进行一次）。节假日 LT 数量较少（P = 0.004）。在工作日或节假日进行的 LT 中，供体、受体和移植相关特征没有实质性差异。在星期一，进行的移植较少（与其他工作日相比：P < 0.0001；与星期日相比：P = 0.03）。在多变量 Cox 回归分析中，节假日或不同工作日进行的 LT 不是 3 个月和 12 个月移植物丢失风险的独立危险因素。在三个月生存曲线中，在节假日与工作日进行的移植之间未观察到差异（86.2%与 85.0%；P-0.70）。基于星期几的移植物存活率范围为 81.6%-86.9%，没有显示出任何显著差异（P = 0.57）。节假日和星期一进行的移植较少。生存不受节假日或移植日的影响。
