ArticleProgress in transplantation (Aliso Viejo, Calif.)2025
A Three Decade Analysis of Trends in Length of Stay After Liver Transplantation.
Article in Progress in transplantation (Aliso Viejo, Calif.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: While survival following liver transplantation has improved over the past 3 decades, few studies have examined the changes over time in hospital length of stay (LOS), a surrogate for healthcare expenditure and an important short-term outcome measure. Research question: The purpose of this study was to compare post-transplantation LOS over the last 3 decades. Design: A cross-sectional analysis of 150 603 adult liver transplant recipients between September 1987 and July 2021 from the UNOS database was conducted. The patients were placed into 3 eras (1987-1989, 1990-1999, and 2000-2021) based on a Join point regression analysis of significant time points of change in LOS trends. Risk factors that were significant in univariate analysis (P < .05) were included in the multivariable Cox regression analysis, which controlled for 29 donor/recipient characteristics. Results: Among adult patients, the average LOS following liver transplantation changed from 51.5 days in 1987 to 16.3 days in 2021, with a relatively steeper decline prior to 2000. On multivariable Cox regression, patients in both the 1987-1989 cohort (hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.52-0.57) and the 1990-1999 cohort (HR: 0.77, CI: 0.76-0.78) had significantly prolonged lengths of stay (HR < 1 associated with later hospital discharge) compared to the 2000-2021 cohort. Conclusions: This analysis found that mean LOS decreased over time in adult liver transplant recipients, even after controlling for donor and recipient-level factors. Future studies are needed to elucidate root cause factors for this decline in LOS over time.
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