| Автор | Solit, Richard, L. |
| Автор | Nash, David, B. |
| Автор | Nathan, Howard, M. |
| Автор | Romano, Paula, J. |
| Автор | Abrams, John, D. |
| Автор | Feldman, Harold, I. |
| Дата выпуска | 1998 |
| dc.description | This project was undertaken to determine whether cen tralization of histocompatibility laboratory services for renal transplants performed within eastern Pennsylvania could improve the efficiency of allograft allocation and short-term allograft function. A nonconcurrent cohort study was performed comparing renal allografts trans planted between September 15, 1993, and September 14, 1994, to those transplanted between September 15, 1994, and September 14, 1995. All allografts were procured and allocated by the Delaware Valley Transplant Program, the organ procurement agency in eastern Pennsylvania. Cold preservation time and delayed allograft function were used to measure efficiency of allograft allocation and short term allograft function, respectively. The mean cold preser vation time was reduced from 25.08 hours to 20.68 hours (P < 0.001). The percentage of delayed allograft function was 19.9 and 17.4 for the pre- and postcentralization groups, respectively (P = 0.5). Therefore, centralization of histocompatibility tissue typing was a regionally ef fective process intervention for reducing cold preserva tion time without adversely impacting short-term graft function. The magnitude of this reduction varied between individual centers. Further investigation is required to determine the effect on long-term allograft function and system wide costs. |
| Издатель | Sage Publications |
| Название | Centralization of Histocompatibility Laboratories: Impact on Organ Allocation Efficiency and Outcomes of Cadaveric Renal Transplantation |
| Тип | Journal Article |
| DOI | 10.1177/106286069801300206 |
| Print ISSN | 1062-8606 |
| Журнал | American Journal of Medical Quality |
| Том | 13 |
| Первая страница | 85 |
| Последняя страница | 88 |
| Аффилиация | Solit, Richard, L., Office of Health Policy and Clinical Outcomes, Department of Surgery, Thomas Jefferson University, Philadelphia |
| Аффилиация | Nash, David, B., Office of Health Policy and Clinical Outcomes |
| Аффилиация | Nathan, Howard, M., Delaware Valley Transplant Program, Philadelphia |
| Аффилиация | Romano, Paula, J., Histocompatibility and Clinical Immunology Laboratory, Hershey Medical Center, Hershey |
| Аффилиация | Abrams, John, D., Delaware Valley Transplant Program, Philadelphia |
| Аффилиация | Feldman, Harold, I., Center for Clinical Epidemiology and the Renal Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania |
| Выпуск | 2 |
| Библиографическая ссылка | Fattal GA, Tanasijevic MJ, Winkelman JWEvolution beyond the shared services model of consolidated hospital clinical laboratories. Arch Pathol Lab Med1995;119:701-705. |
| Библиографическая ссылка | Gilbertson J. , Mango P., McLinden S., et al. The Pittsburgh reference laboratory alliance: A model for laboratory medicine in the 21st century. Am J Clin Pathol 1997;107:387-394. |
| Библиографическая ссылка | Winkelman JW , Wybenga DR Quantification of medical and operational factors determining central versus satellite laboratory testing of blood gases . Am J Clin Pathol 1994;102:7-10. |
| Библиографическая ссылка | Friedman BA, Mitchell W.Integrating information from decentralized laboratory testing sites: The creation of a value-added network. Am J Clin Pathol1993;99:637-642. |
| Библиографическая ссылка | . Markel SF, Venner AM A market analysis approach to bidding for capitated clinical laboratory and pathology service contracts. Arch Pathol Lab Med 1995;119:627-630. |
| Библиографическая ссылка | Berwick DMContinuous improvement as an ideal in health care. N Engl J Med1989;320:53-56. |
| Библиографическая ссылка | Chertow GM, Milford EL, Mackenzie HS, et al. Antigen-independent determinants of cadaveric kidney transplant failure. JAMA1996;276:1732-1736. |
| Библиографическая ссылка | Gjertson DWCenter-dependent transplantation factors: An analysis of renal allografts reported to the United Network for Organ Sharing registry. Clin Transpl1993;445-468. |
| Библиографическая ссылка | Gjertson DW, Terasaki PIThe large center variation in half-lives of kidney transplants. Transplantation1992;53:357-362. |
| Библиографическая ссылка | Cecka JMOutcome statistics of renal transplants with an emphasis on long term survival . Clin Transpl 1994;8:324-327. |
| Библиографическая ссылка | Gjertson DWMultifactorial analysis of renal transplants reported to the United Network for Organ Sharing Registry. Clin Transpl1992;299-317. |
| Библиографическая ссылка | Rosenthal JT , Danovitch GM, Wilkinson A., et al. The high cost of delayed graft function in cadaveric renal transplantation. Transplantation 1991;51:1115. |
| Библиографическая ссылка | Evans RWOrgan procurement expenditures and the role of financial incentives. JAMA1993;269:3113-3118. |
| Библиографическая ссылка | Office of Inspector General.Organ Acquisition Costs: An Overview. Washington, DC: Office of Inspector General, Department of Health and Human Services, 1987. |
| Библиографическая ссылка | lVIcIlrath S, Can Medicare HMOs cope with end-stage renal disease ? AMA News, November 1996;4.3 |
| Библиографическая ссылка | Day L.HCFA ESRD demonstration: Applicants show creativity, initiative in acknowledging changes in ESRD reimbursement. Nephol News & Issues, September 1996;11. |
