; 2Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 3Departments of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan.; 4Departments of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan.; 5Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taiwan Introduction: We explored the relationship between
hospital/surgeon volume and postoperative severe sepsis/graft-failure and mortality. Methods: The Taiwan National Health Insurance Research Database claims data for all patients with end-stage renal disease patients who underwent kidney transplantation between see more January 1, 1999, and December 31, 2007, were reviewed. Surgeons and hospitals were categorized
into two groups based on their patient volume. The two primary outcomes were severe sepsis and graft failure/mortality. The unconditional logistical regressions were done to compute Selleck GSK126 the odds ratios (OR) of outcomes after adjusting for possible confounding factors. Kaplan-Meier analysis was used to calculate the cumulative survival rates of graft failure/death after kidney transplantation during follow-up (1999–2008). Results: The risk of developing severe sepsis in a hospital in which surgeons do few renal transplantations was significant (odds ratio [OR]; p = 0.0115): 1.65 times higher than for a hospital in which surgeons do many. The same trend was true for hospitals with a low volume of renal transplantations (OR = 2.39; p < 0.0001). The likelihood of a graft failure within one year for the low-volume surgeon group was 3.1 times higher than for the high-volume surgeon group (p < 0.0001); the trends were similar for hospital
volume as well. Female patients had a lower risk than did male patients, and patients 55 years old or older, as well as those with a higher Charlson comorbidity index score, had a higher risk of severe sepsis. Conclusion: We conclude that the likelihood of severe sepsis and graft failure/mortality is higher for patients treated in hospitals and by surgeons with a low volume of renal transplantations. Therefore, C-X-C chemokine receptor type 7 (CXCR-7) we hypothesize that defining and exporting best practices through educational outreach, and, if necessary, regulation, must be part of the health policy. AGARWAL LALIT KUMAR Dr Lalit Kumar Agarwal Introduction: BK virus (BKV) is one of the most common viral pathogens affecting kidney allografts. Indian data indicates an incidence of ∼9% for BKV infection. BKV nephropathy (BKVN) is an important complication of renal transplantation with a reported incidence between 1% and 10% in different parts of the world. To determine associated factors, and outcome of BKV in our kidney transplant population in order to improve identification and management. Methods: Kidney transplants from 2008 to 2012 were retrospectively reviewed.