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High-volume Hospitals Recommended for High-Risk Heart Transplants

John Commins, for HealthLeaders Media, May 11, 2011

Older, sicker heart-transplant patients are more likely to be alive a year after their operations if they've been treated at hospitals that do a lot of transplants, a Johns Hopkins School of Medicine study showed.

"There's growing evidence throughout medicine and surgery that the volume of cases done at a given medical center has an impact on outcomes," George J. Arnaoutakis, MD, a general surgery resident at the Johns Hopkins University School of Medicine and the study's leader, said in a media release. "Transplant teams more familiar with a procedure do a better job than those that only do a handful each year."

The findings will be presented at the American Association of Thoracic Surgeons' annual meeting in Philadelphia.

The researchers examined United Network of Organ Sharing data from all of the heart transplants done in the United States between January 2000 and December 2009. The researchers assigned each of the 17,211 patients a risk score, which took into account known risk factors for complications and/or death after heart transplant, including age, race, cause of heart failure, bilirubin and creatinine levels and whether they had been on life support. The higher the score, the greater risk of death one year after transplantation, the study said.

Researchers also ranked the 141 hospitals where the transplants took place into low-, medium- and high-volume centers. Low-volume centers did fewer than six heart transplants a year. High-volume centers performed more than 15 annually. Just 5.4% of heart transplants took place at low-volume centers over that 10-year period, while more than 67% were done at high-volume centers, the Johns Hopkins research showed.

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