Is There a "Weekend Effect" in Multiorgan Transplantation?

Purpose Multiple organ transplant surgeries are complicated, prolonged, resource-heavy procedures which may be adversely affected by the timing of the surgery. We used the United Network of Organ Sharing (UNOS) Organ Registry to evaluate for a "Weekend Effect" on mortality, comparing multiorgan transplant surgeries that occurred on a weekday versus during the weekend. Methods We conducted a retrospective cohort analysis of the UNOS Organ Registry for all multi-organ (i.e. heart and other organ(s)) transplants from 1987 to 2019, comparing mortality rates between weekday transplants (WDT) versus weekend transplants (WET). A multivariate Cox proportional hazard regression analysis was used adjusting for age, sex, diabetes, race, ischemic, time, need for dialysis and/or life support, wait time, and HLA mismatch. The exclusion criteria included age Results 2,518 patients received multiorgan transplants on a weekday versus 804 patients during the weekend. Overall, the 10-year overall-mortality for WDT versus WET was 53.2% and 52.7% respectively, p=0.5120. Although there was a trend for higher non-cardiovascular death in the WDT group versus the WET group (79.7% versus 74.5%) and higher cardiovascular death in the WET group versus the WDT group (25.2% vs 20.3%) the difference did not meet statistical significance with a p=0.053. Conclusion Based on this retrospective cohort analysis of the UNOS Organ Registry, there was no significant mortality "Weekend Effect" observed for multiorgan transplant surgeries.