Liver Transplantation Program in India: The Core-Satellites Model

Background : Liver transplants in India are mostly done in a few large volume centers. There are many small volume centers which use the expertise and support from these large volume centers to carry out liver transplantations. The effectiveness of this model where a core large volume center supports the smaller volume satellite centers has not been evaluated before. Aim : To assess the outcomes of patients transplanted atsatellite centres and monitored remotely and compare them with those transplanted in the core center and managed by an in-house team. Results : The recipients in the satellite centers were younger than those in the core hospital. The other parameters were comparable. The donors were younger in the satellite hospitals than those in the core hospital.The incidence of early graft dysfunction was lesser in the peripheral hospitals than in the core hospital (5 [10.20%] vs 11 [35.48%],p = 0.009). The length of postoperative hospital stay was also lesser among patients operated in the satellite centers (15.96 ± 6.75 vs 20.59 ± 10.14, p = 0.018). Conclusion : This core-satellites model has been shown to be an effective model in the performance of liver transplantations at multiple centers with equivalent outcomes.