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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Case Study (1)
- Children/Adolescents (4)
- Chronic Conditions (1)
- COVID-19 (1)
- Evidence-Based Practice (2)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (1)
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- Newborns/Infants (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
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- (-) Surgery (8)
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- (-) Transplantation (8)
- Vaccination (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 8 of 8 Research Studies DisplayedFeldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Feldman AG, Adams MA, Wachs ME
Successful non-directed living liver donor transplant for an infant with biliary atresia during the COVID-19 pandemic.
This case study describes a successful non-directed living liver donor transplant for an infant with biliary atresia that occurred during the COVID-19 pandemic. Careful preoperative planning was used to prevent infection pre- and post-cooperatively, and robust telehealth technology use both in and out of the hospital.
AHRQ-funded; HS026510.
Citation: Feldman AG, Adams MA, Wachs ME .
Successful non-directed living liver donor transplant for an infant with biliary atresia during the COVID-19 pandemic.
Pediatr Transplant 2020 Dec;24(8):e13816. doi: 10.1111/petr.13816..
Keywords: Newborns/Infants, COVID-19, Transplantation, Surgery, Case Study
Kemme S, Sundaram SS, Curtis DJ
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
The goal of this study was to assess current post-transplant live vaccine practices at individual pediatric liver transplant centers following the updated AST guidelines. Using email surveys with a 93% response rate, findings showed that only 29% of centers offered live vaccines post-transplant, with each center using different eligibility criteria for live vaccines. The main reasons for a center not offering post-transplant live vaccines were safety concerns and inability to reach group consensus.
AHRQ-funded; HS026510.
Citation: Kemme S, Sundaram SS, Curtis DJ .
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
Pediatr Transplant 2020 Aug 26:e13804. doi: 10.1111/petr.13804..
Keywords: Children/Adolescents, Transplantation, Surgery, Vaccination, Practice Patterns
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Brown CS, Wakam GK, Englesbe MJ
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement.
This study looked at recent developments in decision making for use of CDC-labeled increased-risk donor (IRD) use for solid organ transplantation. The implementation of nucleic acid testing for HIV and hepatitis C virus has resulted in decreasing risk of window-period infection often by an order of magnitude or more. However, surgeons still are hesitant to utilize IRD organs. The authors conclude that rate of transmission of window-period infection from IRD organs is exceptionally low and the harms regarding the increased risk classification outweigh the benefits for patients who need organ transplantation.
AHRQ-funded; HS000053.
Citation: Brown CS, Wakam GK, Englesbe MJ .
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement.
Curr Opin Organ Transplant 2020 Apr;25(2):139-43. doi: 10.1097/mot.0000000000000735..
Keywords: Transplantation, Surgery, Risk
Ingraham NE, Tignanelli CJ, Menk J
Pre- and peri-operative factors associated with chronic critical illness in liver transplant recipients.
This study examined whether patients with end-stage liver failure undergoing liver transplant would be at high risk for developing chronic critical illness (CCI). They looked at pre- and perioperative factors associated with CCI. This retrospective cohort study was performed at a large academic transplant center and included all adult liver transplant patients from 2011 to 2017. CCI was defined as the need for mechanical ventilation for seven days or more post-transplant. Recipients who had re-transplantation, acute rejection, or who died during transplant surgery were excluded. They identified 382 transplant recipients, and out of that cohort 45 (11.8%) developed CCI. Eight independent factors were associated with CCI including previous liver transplant, acute renal failure, frailty, lower albumin level, higher international normalized ratio, need for mechanical ventilation and higher systolic pulmonary artery pressure. A higher pre-transplant Model for End-Stage Liver Disease (MELD) score was associated with protection against CCI.
AHRQ-funded; HS026379.
Citation: Ingraham NE, Tignanelli CJ, Menk J .
Pre- and peri-operative factors associated with chronic critical illness in liver transplant recipients.
Surg Infect 2020 Apr;21(3):246-54. doi: 10.1089/sur.2019.192..
Keywords: Chronic Conditions, Transplantation, Surgery, Outcomes
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Feldman AG, Atkinson K, Wilson K
Underimmunization of the solid organ transplant population: An urgent problem with potential digital health solutions.
This paper describes ways that digital health technologies may help solid organ transplant recipients stay free from vaccine-preventable infections so they are not underimmunized at the time of transplant and thereafter. Due to vaccine hesitancy and refusal in the general population, recipients can no longer rely on herd immunity to protect them. Digital health technologies can provide accurate information about vaccine safety, efficacy and timing in the pre- and post-transplant periods; make complete immunization records universally available and easily accessible; enable communication between patients and multiple providers; and provide automated vaccine reminders to both patients and providers.
AHRQ-funded; HS026510.
Citation: Feldman AG, Atkinson K, Wilson K .
Underimmunization of the solid organ transplant population: An urgent problem with potential digital health solutions.
Am J Transplant 2020 Jan;20(1):34-39. doi: 10.1111/ajt.15605..
Keywords: Transplantation, Surgery, Healthcare Utilization, Infectious Diseases, Telehealth, Health Information Technology (HIT), Vaccination