Impact of nighttime procedures on outcomes after liver transplantation

BACKGROUND: Sleep deprivation is a well-known risk factor for the performance of medical professionals. Solid organ transplantation (especially orthotopic liver transplantation (oLT)) appears to be vulnerable since it combines technically challenging operative procedures with an often unpredictable...

Verfasser: Becker, Felix
Voß, Thekla
Mohr, Annika
Mehdorn, Anne-Sophie
Schütte-Nütgen, Katharina
Reuter, Stefan Johannes
Kabar, Iyad
Bormann, Eike
Vowinkel, Thorsten
Palmes, Daniel Michael
Brockmann, Jens G.
Pascher, Andreas
Bahde, Ralf
Kebschull, Linus
Vogel, Thomas
FB/Einrichtung:FB 05: Medizinische Fakultät
Dokumenttypen:Artikel
Medientypen:Text
Erscheinungsdatum:2019
Publikation in MIAMI:01.07.2020
Datum der letzten Änderung:01.07.2020
Angaben zur Ausgabe:[Electronic ed.]
Quelle:PLoS ONE 14 (2019) 7, e0220124, 1-18
Fachgebiet (DDC):610: Medizin und Gesundheit
Lizenz:CC BY 4.0
Sprache:English
Förderung:Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF-Dokument
URN:urn:nbn:de:hbz:6-50189535824
Weitere Identifikatoren:DOI: 10.1371/journal.pone.0220124
Permalink:https://nbn-resolving.de/urn:nbn:de:hbz:6-50189535824
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Onlinezugriff:artikel_becker_2019.pdf

BACKGROUND: Sleep deprivation is a well-known risk factor for the performance of medical professionals. Solid organ transplantation (especially orthotopic liver transplantation (oLT)) appears to be vulnerable since it combines technically challenging operative procedures with an often unpredictable start time, frequently during the night. Aim of this study was to analyze whether night time oLT has an impact on one-year graft and patient survival. MATERIAL AND METHODS: Deceased donor oLTs between 2006 and 2017 were retrospectively analyzed and stratified for recipients with a start time at day (8 a.m. and 6 p.m.) or at night (6 p.m. to 8 a.m.). We examined donor as well as recipient demographics and primary outcome measure was one-year patient and graft survival. RESULTS: 350 oLTs were conducted in the study period, 154 (44%) during daytime and 196 (56%) during nighttime. Donor and recipient variables were comparable. One-year patient survival (daytime 75.3% vs nighttime 76.5%, p = 0.85) as well as graft survival (daytime 69.5% vs nighttime 73.5%, p = 0.46) were similar between the two groups. Frequencies of reoperation (daytime 53.2% vs nighttime 55.1%, p = 0.74) were also not significantly different. CONCLUSION: Our retrospective single center data derived from a German transplant center within the Eurotransplant region provides evidence that oLT is a safe procedure irrespective of the starting time. Our data demonstrate that compared to daytime surgery nighttime liver transplantation is not associated with a greater risk of surgical complications. In addition, one-year graft and patient survival do not display inferior results in patients undergoing nighttime transplantation.