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Operative Time of Day Not Tied to Transplant Survival

Clinical outcomes at one year are not associated with time of thoracic organ transplantation

TUESDAY, May 31 (HealthDay News) -- The operative time of day does not significantly affect one-year survival of thoracic transplant recipients, according to a study published in the June 1 issue of the Journal of the American Medical Association.

Timothy J. George, M.D., from the Johns Hopkins Medical Institutions in Baltimore, and colleagues evaluated the association between the timing of transplant operations and outcomes in 27,118 adult recipients of heart (16,573) and lung (10,545) transplants from 2000 to 2010. Participants were stratified according to the time of operation, from 7 p.m. to 7 a.m. (night), or from 7 a.m. to 7 p.m. (day). They were followed up for an average 32.2 months, during which time, short-term survival at 30, 90, and 365 days was measured, and postoperative complications and mortality were assessed.

The investigators identified a total of 8,061 deaths. Survival rates at 30, 90, and 365 days were similar for heart transplant operations performed during the day or night. For lung transplants, survival rates for operations performed during the day or night were similar at 30 days and 365 days, but were significantly different at 90 days (hazard ratio at 30 days day versus night, 1.22 [P = 0.09]; 90 days day versus night, 1.23 [P = 0.02]; and 365 days day versus night, 1.08 [P = 0.19]). For lung transplant recipients, transplant at night was associated with a slightly but significantly higher rate of airway dehiscence compared to day transplants (1.7 versus 1.1 percent).

"Among patients who underwent thoracic organ transplants, there was no significant association between operative time of day and survival up to one year after organ transplant," the authors write.

One of the study authors disclosed a financial relationship with the medical device industry.

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