Does Surgeon Fatigue Influence the Results of Liver Transplantation?

Abstract

Background: Recently, there has been an attempt to relate fatigue of the surgical team according to the start time of the transplant surgery and the surgeon's activity during the week, with the morbidity and mortality of liver transplant recipients. If this relationship could be demonstrated, it would be desirable to reconsider organization of transplant surgical teams.

Methods: We carried out a retrospective study of 439 successive cases of adult hepatic transplant from 2012 to 2016. We divided the patients into 2 groups, bearing in mind the interval between transplant procedures. Solitary liver transplantation was defined when >12 hours had elapsed since the last transplant, and consecutive liver transplant was defined when <12 hours had passed since the previous transplant. We analyzed the morbidity and mortality of the recipient (survival, vascular and biliary complications, early bleeding, and duration of surgery). Fatigue was measured as it related to the start time of the transplant, day of the week, and accumulation of daily and weekly activity of the surgical teams.

Results: No significant differences were found between the 2 groups with regard to donor or recipient characteristics. No variable related to the fatigue of the surgeons had an effect on the survival, biliary and vascular complications, early bleeding, or duration of the surgical intervention.

Conclusion: We were unable to show that fatigue level of the surgical team influences the results of transplant procedures. Morbidity and mortality are likely related to other factors.