Singapore surgeons perform a combined heart and liver transplant. New… (Roslan Rahman / AFP/Getty…)
Medical errors tend to occur more frequently at night and on weekends due to increased sleepiness, shortage of staff and a variety of other factors. Overall, such errors represent a significant problem for the medical community. A 1999 report from the Institute of Medicine showed that all medical errors -- including daytime errors, as well as night and weekend mistakes -- cause as many as 98,000 deaths each year and cost as much as $29 billion annually. Transplants are considered a source of concern by many experts because the surgeries occur when organs become available, and that is just as likely to be at an off-hour as during normal business hours.
Dr. A. Sidney Barritt IV of the University of North Carolina at Chapel Hill and his colleagues decided to check the safety records of liver transplants. Using a database of the United Network of Organ Sharing, they identified 94,768 adult liver transplants that occurred between 1987 and 2010, segregating them by time of day and day of the week. Transplants that occurred between 7 p.m and 7 a.m. were defined as nighttime operations, while those that took place between 5 p.m. on Friday and 8 a.m. on Monday were defined as weekend procedures.
The team reported in the journal Liver Transplantation that 30-, 90- and 365-day survival rates for nighttime operations were 96%, 93% and 86%, respectively, virtually the same as for procedures performed during normal business hours. The rates for weekend procedures were nearly identical: 95%, 92% and 86%.
The team suggested that the use of a full transplant team, even for off-hour procedures, was probably the reason the surgeries were so successful. "It is reassuring to patients and transplant specialists to see that patient outcomes are not affected by the timing of the transplant," Barritt said.