Pediatric Liver Transplant

A liver transplant is a surgical procedure where a patient has a healthy liver from a donor implanted. Most liver transplant operations use livers from deceased donors, though a liver may also come from a living donor.

Liver transplant is a treatment option for people who have liver failure that cannot be controlled using other treatments and for some people with liver cancer. Liver failure has many causes, including cirrhosis, early-stage liver cancer, chronic hepatitis C, hemochromatosis (too much iron absorbed by the liver) and Wilson's disease (too much copper absorbed by the liver).

The number of people waiting for liver transplant is much larger than the number of available livers, so liver transplant is reserved for people who are critically ill. Some people may spend months waiting for a liver transplant.

Procedure volume is the number of times a procedure was performed and is often used to assess clinical experience and expertise. Studies have linked higher volumes with more successful outcomes for some types of procedures.

The data below is based on liver transplants done at C.S. Mott Children's Hospital in patients less than 18 years old.

Number of Liver Transplants

Details

Why is This Measure Important?

Health systems that perform a high number of liver transplants are more likely to have better outcomes, such as better survival rates. Unfortunately, there is no agreed upon standard or threshold that defines high volume so it is important to consider volume along with other measures, like process and outcome measures. This is a measure of the volume, or number of liver transplants.

How is UMHS Performing?

In 2013, surgeons at the University of Michigan Health System performed 12 liver transplants for children and a total of 70 liver transplants for patients of all ages.

According to the U.S. Scientific Registry of Transplant Recipients, typical liver transplant rate is 11.2%, UMHS has a rate of 19.2%. Our volume of transplants for children and for patients of all ages is high compared to the volume at other health systems, demonstrating that UMHS has considerable experience in liver transplantation.

UMHS Source: Hospital administrative data.
Comparison Group Source: None.

In this section, we evaluate the success of the liver transplants by measuring outcomes such as patient and graft survival. Because the severity of disease differs between patients, some patients have a higher risk of death. So, we compare our actual performance to what is expected given the risk of the patients we treat. The expected survival rate is provided by the U.S. Scientific Registry of Transplant Recipients (SRTR). For all measures, percentages that are higher than the SRTR expected rate mean better performance.

Patient Survival Rates After Transplant
Higher Value = Better Performance

Details

Why is This Measure Important?

Patient survival is a measure of the success of the liver transplant. This measure represents the percentage of pediatric patients who survived 1 month, 1 year and 3 years after liver transplant. The actual patient survival rates for the University of Michigan Health System are compared to the expected rates for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our transplant population, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

How is UMHS Performing?

The University of Michigan Health System's pediatric patient survival rate is slightly lower than expected at 1 month, 1 year and 3 years after liver transplant, based on results from SRTR. The differences are not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR.

Graft Survival Rates After Transplant
Higher Value = Better Performance

Details

Why is This Measure Important?

A "graft" refers to the transplanted organ. Graft survival is a measure of the success of the liver transplant. Sometimes the transplant, or graft, may fail, but the person may survive. This measure represents the percentage of grafts for pediatric patients that survived 1 month, 1 year and 3 years after liver transplant. The actual graft survival rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our transplant population, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

How is UMHS Performing?

The University of Michigan Health System's pediatric graft survival rate is slightly higher than expected at 1 month, but lower at 1 year and 3 years after liver transplant. The differences in the rates are not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR.