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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2979-2987. Prepublished online as a Blood First Edition Paper on December 14, 2004; DOI 10.1182/blood-2004-10-3863. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-10-3863v1 105/7/2979    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Loberiza, F. R. Articles by Rizzo, J. D. Search for Related Content PubMed PubMed Citation Articles by Loberiza, F. R., Jr Articles by Rizzo, J. D. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Association of transplant center and physician factors on mortality after hematopoietic stem cell transplantation in the United States Fausto R. Loberiza, Jr, Mei-Jie Zhang, Stephanie J. Lee, John P. Klein, Charles F. LeMaistre, Derek S. Serna, Mary Eapen, Christopher N. Bredeson, Mary M. Horowitz, and J. Douglas Rizzo From the University of Nebraska Medical Center, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI; Dana-Farber Cancer Institute, Boston, MA; and Texas Transplant Institute, San Antonio, TX. The effect of the organization and delivery of health care at medical centers, referred to as "center effects," with clinical outcomes after hematopoietic stem cell transplantation (HSCT) is not clear. We examined the association between center and treatment provider factors and mortality after HSCT. We surveyed 163 (87% response rate) United States transplantation centers that performed HLA-identical sibling HSCT for leukemia or autologous HSCT for lymphoma between 1998 and 2000 among patients at least 18 years old. One hundred thirteen (69%) centers performed HLA-identical sibling transplantations, whereas 162 (99%) performed autologous transplantations. Factors associated with decreased 100-day mortality in the allogeneic setting include a higher patient-per-physician ratio (P = .003) and centers where physicians answer calls after office hours (P = .03). Medical school affiliation was not associated with increased 100-day mortality except in centers where students/residents are present without fellows (P = .02). Center effects were weaker in autologous HSCT at 1 year. Differences in 100-day mortality in patients receiving transplants in centers with favorable versus unfavorable factors were greater in allogeneic than autologous HSCT. Greater physician involvement in patient care is important in producing favorable outcomes after HSCT. To more clearly establish the role of the factors we identified, further studies are recommended. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: R. K. Burt, A. Traynor, L. Statkute, W. G. Barr, R. Rosa, J. Schroeder, L. Verda, N. Krosnjar, K. Quigley, K. Yaung, et al. Nonmyeloablative Hematopoietic Stem Cell Transplantation for Systemic Lupus Erythematosus JAMA, February 1, 2006; 295(5): 527 - 535. [Abstract] [Full Text] [PDF]

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