Grant: Project Grant

For patients with end-stage organ failure, transplantation is lifesaving and improves quality of life. Because more people are receive a transplant each year, and patients with transplants are living longer, the number of patients living with a transplant in Canada increases each year. The success and expansion of organ transplantation has resulted in a large number of transplant recipients that routinely require care outside of transplant centres for non-transplant issues such as emergency general surgery (EGS) conditions such as inflammation of the gallbladder or the appendix. EGS patients have 8-fold higher mortality and 50% more complications compared to non-emergent general surgical patients such as those coming in for planned bowel resections. Multiple small studies suggest even worse outcomes amongst the transplant population who suffer EGS conditions likely because their immune system needs to be suppressed. EGS conditions are of particular importance in the solid organ transplant population given their high incidence, morbidity, and mortality. This study will use information from a registry of all patients having a solid organ transplant in Ontario linked to information from large administrative databases that capture most healthcare interactions in Ontario. We are interested in evaluating if transplant patients develop EGS conditions more frequently, have more complications, and/or higher death rates compared to non-transplant patients. We will be able to understand how EGS conditions are treated in transplant vs. non-transplant patients as well as if there are differences in transplant vs. non-transplant hospitals. If we identify differences in strategies that lead to less complications or death in transplant patients we can then develop and disseminate these strategies to improve outcomes. We will gather together experts in the field of transplantation and EGS care in order for the results of our study to be maximally useful and have an impact.