Key principles for launching a new organ transplant center: preliminary results

Abstract

Introduction: In organ transplantation, there is no standardized protocol-based approach from patient selection to treatment and postoperative follow-up in our country. Both in Europe and the United States of America, both national and centers have their own protocols and accordingly, a standardized decision mechanism works and successful results are achieved. Our aim is to examine the principles of working with a new center and a new transplant team to be established in a hospital that has not worked as a transplant center before, and how the necessary conditions for an ideal transplant center can be created, so that the best results can be obtained while establishing a center and to share the first experiences of our center. Material and Method: The protocols developed following the establishment of the newly established transplant center between October 2023 and January 2024 and the early results of 13 kidney and 15 liver transplants performed in the center were examined. Results: All 13 liver transplant operations were performed in adult patients, 11 (84%) were living donor and 2 were cadaveric liver transplants. The median MELD-Na score was 17.5 and the median operation time was 410 (min-max: 345-470) minutes. 1 patient had portal vein thrombosis and thrombectomy was performed. Except for 2 cadaveric patients, 11 patients underwent right lobe graft transplantation. None of the patients had hepatic artery thrombosis, portal vein thrombosis, bile leakage, primary graft nonfunction, organ rejection, surgical site infection, viral infection or sepsis. 15 patients underwent kidney transplantation, of which two were cadaveric and 13 (86%) were living donor transplants. The median operation time was 175 (min-max: 145-210) minutes. 13 patients (86%) had left and 2 patients had right kidney graft transplantation. The median hospital stay was 7 (min-max: 6-14) days. Renal artery thrombosis, renal vein thrombosis, urinary leakage, organ rejection, surgical site infection, viral infection or sepsis were not observed in any of the patients. Conclusion: Starting from patient selection, providing quality health care to patients by establishing protocols that ensure standardization of care and follow-up is beneficial to minimize morbidity and mortality and reach high survival levels. We think that it is possible to achieve higher success in organ transplantation nationally by contributing more to the literature of the operational disruptions and development opportunities experienced in transplant centers.