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建立机构肝移植登记系统:机遇与挑战。

The building of an institutional liver transplant registry: opportunities and challenges.

机构信息

Hospital Italiano de Buenos Aires, Liver Unit, Buenos Aires, Argentina.

Hospital Italiano de Buenos Aires, Research Department, Buenos Aires, Argentina.

出版信息

J Int Med Res. 2024 Jul;52(7):3000605241264232. doi: 10.1177/03000605241264232.

Abstract

To improve current data systems for institutional decision-making, the Adult Liver Transplant Registry was established at the Hospital Italiano de Buenos Aires, Argentina. This article describes its design and implementation and reports on the outcomes for patients transplanted since its January 2020 launch. A multidisciplinary team designed the registry by identifying key variables from a literature review while considering balance between data depth and feasibility. Rigorous quality control measures were enforced, including monthly audits and staff training. Benchmark indicators for post-transplant outcomes were established. As of November 2023, the registry included 136 transplants. Its implementation and maintenance were straightforward, with no significant difficulties encountered. Cirrhosis was the predominant indication (77%) for transplant. Only one living donor transplantation was performed. Post-transplant results generally aligned with benchmarks, but rates of biliary complications slightly exceeded the recommended thresholds. The one-year post-transplant survival rate was 87%. The successful registry implementation provides a robust framework for research, treatment management, and patient care enhancement within a liver transplant unit.

摘要

为了改善机构决策的现有数据系统,阿根廷布宜诺斯艾利斯意大利医院成立了成人肝移植登记处。本文描述了其设计和实施情况,并报告了自 2020 年 1 月推出以来接受移植的患者的结果。一个多学科团队通过从文献综述中确定关键变量来设计该登记处,同时考虑数据深度和可行性之间的平衡。实施了严格的质量控制措施,包括每月审核和员工培训。建立了移植后结果的基准指标。截至 2023 年 11 月,该登记处包括 136 例移植。其实施和维护简单,没有遇到重大困难。移植的主要适应症是肝硬化(77%)。仅进行了一次活体供者移植。移植后的结果通常与基准一致,但胆道并发症的发生率略高于推荐的阈值。移植后一年的生存率为 87%。成功实施登记处为肝移植单位的研究、治疗管理和患者护理提供了一个强大的框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cccc/11295234/37b0f59b19be/10.1177_03000605241264232-fig1.jpg

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