Adult Organ Transplant Service JAWDA Performance Indicators

Adult Organ Transplant

Service Jawda Guidance
Version 1
 Adult Organ Transplant Service JAWDA Performance Indicators

Table of Contents
Executive Summary ....................................................................................................................... 3
About this Guidance ....................................................................................................................... 4
Patient Survival Rate (one year) after Primary Organ Transplantation ................................... 5
Patient Survival Rate (three years) after Primary Organ Transplantation ............................... 6
Graft Survival Rate (one year).................................................................................................... 7
Graft Survival Rate (five years) .................................................................................................. 8
Biliary Complication after Primary Liver Transplantation ..................................................... 10
Severe Primary Graft Dysfunction after Primary Heart Transplantation ............................... 11
Bronchial and Vascular Complications after Primary Lung Transplantation ......................... 12
Average Primary Organ Transplantation Wait Time ............................................................... 13
Primary Organ Transplantation Waitlist Mortality Rate ......................................................... 14
Appendix: Transplantation complication codes ............................................................................... 15

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 Adult Organ Transplant Service JAWDA Performance Indicators
Executive Summary
The Department of Health– Abu Dhabi (DOH) is the regulatory body of the healthcare sector in
the Emirate of Abu Dhabi and ensures excellence in healthcare for the community by
monitoring the health status of its population.

The Emirate of Abu Dhabi is experiencing a substantial growth in the number of hospitals,
centers and clinics. This is ranging from school clinics and mobile units to internationally
renowned specialist and tertiary academic centers. Although, access and quality of care has
improved dramatically over the last couple of decades, mirroring the economic upturn and
population boom of Emirate of Abu Dhabi, however challenges remain in addressing further
improvements.

The main challenges that are presented with increasingly dynamic population include an aging
population with increased expectation for treatment, utilization of technology and diverse
workforce leading to increased complexity of healthcare provision in Abu Dhabi. All of this
results in an increased and inherent risk to quality and patient safety.

DOH has developed dynamic and comprehensive quality framework in order to bring about
improvements across the health sector. This guidance relates to the quality indicators that DOH
is mandating the quarterly reporting against by the operating general and specialist hospitals
in Abu Dhabi.

The guidance sets out the full definition and method of calculation for patient safety and
clinical effectiveness indicators. For enquiries about this guidance, please contact
[email protected]

This document is subject for review and therefore it is advisable to utilize online versions
available on the DOH at all times.

Issued: December 2024, Version 1

Effective: January 2025 (Q1 2025)

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 Adult Organ Transplant Service JAWDA Performance Indicators
About this Guidance
The guidance sets out the definitions and reporting frequency of JAWDA Adult Organ
Transplantation (AOT) performance indicators. The Department of Health (DoH), with
consultation from local and international experts, has developed Adult Organ Transplantation
Performance Indicators that are aimed for assessing the degree to which a provider
competently and safely delivers the appropriate clinical services to the patient within the
optimal period of time.

This Jawda KPI guidance includes measures to monitor morbidity and mortality in patients
undergoing Adult Organ Transplantation procedures. Healthcare providers are the most
qualified professionals to develop and evaluate quality of care for Adult Organ Transplantation
patients; therefore, it is crucial that clinicians retain a leadership position in defining
performance among Adult Organ Transplantation healthcare providers.

Who is this guidance for?

All DoH licensed healthcare facilities providing adult Organ Transplant services in the Emirate
of Abu Dhabi.

*The patient's age at the time of registration on the waiting list is used to classify pediatric (listed
before their 18th birthday) and adult patients.

How do I follow this guidance?

Each provider will nominate one member of staff to coordinate, collect, monitor and report
Organ Transplant quality indicators data as per communicated dates. The nominated
healthcare facility lead must in the first instance e-mail their contact details (if different from
previous submission) to [email protected] and submit the required quarterly quality
performance indicators through Jawda online portal.

What are the Regulation related to this guidance?

• Legislation establishing the Health Sector
• As per DoH Policy for Quality and Patient Safety issued January 15th 2017, this guidance
applies to all DOH Licensed Healthcare Facilities in the Emirate of Abu Dhabi in accordance
with the requirements set out in this Standard
• DOH Standard for Centers of Excellence in the Emirate of Abu Dhabi issued March 2019

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 Adult Organ Transplant Service JAWDA Performance Indicators

Type: AOT Quality Indicator Indicator Number: AOT001

KPI Description
(title): Patient Survival Rate (one year) after Primary Organ Transplantation
Domain Effectiveness
Indicator Type Outcome
Percentage of adult primary organ transplant recipients who survive for one year
after transplantation.
This KPI reflects the long-term outcomes and quality of care provided by the
Definition:
program.
This is calculated on a rolling survival rate of a 2-and-a-half-year patient cohort reported every 6
months.
Numerator: Number of adult primary organ transplant recipients in the cohort
who survive for one year after primary organ transplantation i.e. through day 365
post-transplant.

Numerator Inclusion:
• Patient survival includes follow-up after graft failure, retransplant, and
return to maintenance dialysis in the case of kidney recipients.
• Patients not reported to have died in any relevant data source are assumed
to be alive.

Denominator: Total number of adult primary organ transplant recipients during

the accrual period.

Denominator Inclusions:
Single primary organ transplants occur during the accrual period.
Day of transplantation is day “0”.
Calculation:
Note: Report the number of deaths and patient days for each transplant separately.
a) Kidney transplant from living donors
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

Denominator Exclusion:
• Age less than 18 years at time of transplantation.
• Loss to follow-up (Patients with unknown survival status who may have
died outside the UAE).
• Multiorgan transplantations
o A multi-organ transplant is defined as receiving more than one
organ from the same deceased donor.
o A living donor kidney transplanted with a deceased donor pancreas
is considered a multi-organ transplant if the two transplants took
place within 3 days of each other.
Reporting
Semiannually
Frequency:
Unit of Measure: Percentage of patients surviving at one year after primary organ transplantation.
International Scientific Registry of Transplant Recipients
comparison if https://www.srtr.org/reports/psr-reporting-timeline/
available https://www.cedars-sinai.org/quality-measures/clinical/transplants.html

Adult (1-year patient survival)

Desired direction:
Kidney transplant from living donors 98%
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 Adult Organ Transplant Service JAWDA Performance Indicators
Kidney transplant from deceased donors 96%
Liver Transplant 91.7%
Heart Transplant 91.1%
Lung Transplant 87.8%

Data sources and -Patient medical record

guidance: -Hospital administrative data

Type: AOT Quality Indicator Indicator Number: AOT002

KPI Description Patient Survival Rate (three years) after Primary Organ
(title): Transplantation
Domain Effectiveness
Indicator Type Outcome
Percentage of adult primary organ transplant recipients who survive for three years
after transplantation.
This KPI reflects the long-term outcomes and quality of care provided by the
Definition:
program.
This is calculated on a rolling survival rate of a 2-and-a-half-year patient cohort
reported every 6 months.
Numerator: Number of adult primary organ transplant recipients in the cohort
who survive for three years after primary organ transplantation i.e. through day
1095 post-transplant.

Numerator Inclusion:
• Patient survival includes follow-up after graft failure, retransplant, and
return to maintenance dialysis in the case of kidney recipients.
• Patients not reported to have died in any relevant data source are assumed
to be alive.

Denominator: Total number of adult primary organ transplant recipients during

the accrual period.

Denominator Inclusions:
Single primary organ transplants occur during the accrual period.
Calculation: Day of transplantation is day “0”.

Note: Report the number of deaths and patient days for each transplant separately.
a) Kidney transplant from living donors
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

Denominator Exclusion:
• Age less than 18 years at time of transplantation.
• Loss to follow-up (Patients with unknown survival status who may have
died outside the UAE).
• Multiorgan transplantations
o A multi-organ transplant is defined as receiving more than one
organ from the same deceased donor.

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 Adult Organ Transplant Service JAWDA Performance Indicators
o A living donor kidney transplanted with a deceased donor pancreas
is considered a multi-organ transplant if the two transplants took
place within 3 days of each other.
Reporting
Semiannually
Frequency:
Unit of Measure: Percentage of patients surviving at three years after primary organ transplantation
International Scientific Registry of Transplant Recipients
comparison if https://www.srtr.org/reports/psr-reporting-timeline/
available https://www.cedars-sinai.org/quality-measures/clinical/transplants.html

Kidney transplant from living donors 94%

Kidney transplant from deceased donors 87%
Desired direction:
Heart Transplant 81%
Lung Transplant 60.5%

Data sources and -Patient medical record

guidance: -Hospital administrative data

Type: AOT Quality Indicator Indicator Number: AOT003

KPI Description
(title): Graft Survival Rate (one year)
Domain Effectiveness
Indicator Type Outcome
Percentage of adult primary organ transplant recipients who have a functioning
transplanted organ one year after transplantation.
This KPI reflects the long-term outcomes and quality of care provided by the
Definition:
program.
This is calculated on a rolling survival rate of a 2-and-a-half-year patient cohort
reported every 6 months.
Numerator: Number of adult primary organ transplant recipients in the cohort
who have a functioning transplanted organ one year after primary organ
transplantation i.e. through day 365 post-transplant.

Numerator Inclusion:
A graft is counted as failed if there has been graft failure, a retransplant, or death.

Denominator: Total number of adult primary organ transplant recipients during

the accrual period.

Calculation: Denominator Inclusions:

Single primary organ transplants occur during the accrual period.
Day of transplantation is day “0”.

Note: Report the number of deaths and patient days for each transplant separately.
a) Kidney transplant from living donors
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

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 Adult Organ Transplant Service JAWDA Performance Indicators
Denominator Exclusion:
• Age less than 18 years at time of transplantation.
• Loss to follow-up (Patients with unknown survival status who may have
died outside the UAE).
• Multiorgan transplantations
o A multi-organ transplant is defined as receiving more than one
organ from the same deceased donor.
o A living donor kidney transplanted with a deceased donor pancreas
is considered a multi-organ transplant if the two transplants took
place within 3 days of each other
Reporting
Semiannually
Frequency:
Unit of Measure: Percentage
• Scientific Registry of Transplant Recipients
International • https://www.srtr.org/reports/psr-reporting-timeline/
• https://www.cedars-sinai.org/quality-measures/clinical/transplants.html
comparison if
• https://www.kidney-international.org/action/showPdf?pii=S0085-2538%2820%2930906-6
available
• https://optn.transplant.hrsa.gov/media/r5lmmgcl/mpsc_performancemetrics_3242022b.pdf

Adult (1-year graft survival)

Desired direction: 1 year graft survival for living donor kidney transplantation. 93%
1 year graft survival for deceased donor kidney transplantation 92%

Data sources and -Patient medical record

guidance: -Hospital administrative data

Type: AOT Quality Indicator Indicator Number: AOT004

KPI Description
(title): Graft Survival Rate (five years)
Domain Effectiveness
Indicator Type Outcome
Percentage of adult primary organ transplant recipients who have a functioning
transplanted organ five years after transplantation.
This KPI reflects the long-term outcomes and quality of care provided by the
Definition:
program.
This is calculated on a rolling survival rate of a 2-and-a-half-year patient cohort
reported every 6 months.
Numerator: Number of adult primary organ transplant recipients in the cohort who
have a functioning transplanted organ five years after primary organ transplantation
i.e. through day 1825 post-transplant.

Numerator Inclusion:
A graft is counted as failed if there has been graft failure, a retransplant, or death.
Calculation:
Denominator: Total number of adult primary organ transplant recipients during
the accrual period.

Denominator Inclusions:
Single primary organ transplants occur during the accrual period.
Day of transplantation is day “0”.

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 Adult Organ Transplant Service JAWDA Performance Indicators
Note: Report the number of deaths and patient days for each transplant separately.
a) Kidney transplant from living donors
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

Denominator Exclusion:
• Age less than 18 years at time of transplantation.
• Loss to follow-up (Patients with unknown survival status who may have died
outside the UAE).
• Multiorgan transplantations
o A multi-organ transplant is defined as receiving more than one organ
from the same deceased donor.
o A living donor kidney transplanted with a deceased donor pancreas
is considered a multi-organ transplant if the two transplants took
place within 3 days of each other
Reporting
Semiannually
Frequency:
Unit of Measure: Percentage
Scientific Registry of Transplant Recipients
International https://www.srtr.org/reports/psr-reporting-timeline/
comparison if https://www.cedars-sinai.org/quality-measures/clinical/transplants.html
available https://www.kidney-international.org/action/showPdf?pii=S0085-2538%2820%2930906-6
https://optn.transplant.hrsa.gov/media/r5lmmgcl/mpsc_performancemetrics_3242022b.pdf
Adult (5-year graft survival)
Desired direction: 5 year graft survival for living donor kidney transplant 80%
5 year graft survival for deceased donor kidney transplant 70%

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators
Type: AOT Quality Indicator Indicator Number: AOT005

KPI Description
(title): Biliary Complication after Primary Liver Transplantation
Domain Safety
Indicator Type Outcome
Rate of biliary complications that occur within 90 days after primary liver
Definition: transplantation that requires procedural interventions and not associated with
procedural interventions.
Numerator: Number of adult liver transplant recipients who develop any of the
following biliary complications within 90 days of the transplant surgery and which
require procedural interventions.

(Refer to Appendix)
• Ischemic biliary complications due to hepatic artery thrombosis or stenosis
• Stricture
• Technical biliary complications
• Ischemic-type biliary lesions
• Infectious biliary complications/cholangitis

Numerator guidance: Complications will be reported separately for:

AOT005a) Whole organ transplantation
AOT005b) Partial liver transplantation
Calculation:
Denominator: Total number of adult patients who had undergone primary
orthotopic liver transplant surgery during the reporting period.

Denominator Inclusion:
• Partial and whole-organ liver transplantation
• Single organ transplants occurring during the measurement period.

Denominator exclusion:
• Age less than 18 years at time of transplantation.
• Living related liver transplant
• Strictures associated with acute cellular rejection
• Patients discharged against medical advice

Reporting
Semi-annually
Frequency:
Unit of Measure: Percentage
International https://karger.com/dsu/article-pdf/25/4/245/2673358/000144653.pdf
comparison if https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856868/
available https://hbsn.amegroups.org/article/view/29779/html

Desired direction: < 28%

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators
Type: AOT Quality Indicator Indicator Number: AOT006

KPI Description
(title): Severe Primary Graft Dysfunction after Primary Heart Transplantation
Domain Safety
Indicator Type Outcome
Rate of severe primary graft dysfunction (PGD) that occurs within 24 hours after
Definition:
primary heart transplantation.
Numerator: Number of adult patients who developed severe primary graft
dysfunction (PGD) within 24 hours after primary heart transplantation:

Numerator Inclusion: (Refer to Appendix)

Either of the two categories:
• PGD-LV, for PGD affecting the left ventricle or biventricular failure with
extracorporeal short-term mechanical circulatory support
• PGD-RV for isolated right ventricular involvement with right-sided short-
term VAD (RVAD) or right heart catheter measured haemodynamics in
keeping with isolated right-sided dysfunction (RAP > 15 mmHg, PCWP < 15
mmHg, CI < 2.0 L/min/m2, TPG < 15 mmHg and/or pulmonary artery
systolic pressure < 50 mmHg)
Calculation:
Denominator: Total number of adult patients who had undergone primary heart
transplant surgery during the reporting period.

Denominator Inclusion:
• Heart donation after circulatory death
• Heart donation after brain death
• Single organ transplants occurring during the measurement period.

Denominator exclusion:
• Age less than 18 years at time of transplantation.
• Patients discharged against medical advice

Reporting
Semi-annually
Frequency:
Unit of Measure: Percentage
https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-
International 02816-6
comparison if https://www.ahajournals.org/doi/10.1161/circ.146.suppl_1.11945
available https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697758/

Desired direction: < 16%

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators
Type: AOT Quality Indicator Indicator Number: AOT007

KPI Description Bronchial and Vascular Complications after Primary Lung

(title): Transplantation
Domain Safety
Indicator Type Outcome
Rate of all bronchial and vascular complications that occur within 1 year after
Definition:
primary lung transplantation (LT).
Numerator: Number of adult patients who developed a bronchial and vascular
complications within one year after primary lung transplantation that required
procedural interventions:

Numerator Inclusion: (Refer to Appendix)

Bronchial (Airway) Complications:
• Bronchial dehiscence
• Bronchial anastomotic stenosis
• Non-anastomotic stenosis
• Tracheobronchomalacia (TBM)
Vascular Complications:
• Pulmonary embolism
• Arterial stenosis
Calculation:
• Venous stenosis
• Venous thrombosis

Denominator: Total number of adult patients who had undergone primary lung
transplant surgery during the reporting period.

Denominator inclusion:
• Single LT
• Bilateral LT

Denominator exclusion:
• Age less than 18 years at time of transplantation.
• Patients discharged against medical advice
Reporting
Semi-annually
Frequency:
Unit of Measure: Percentage
https://pubs.rsna.org/doi/full/10.1148/ryct.2021190252
International
https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-
comparison if
02731-w/tables/1
available

Desired direction: < 20%

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators
Type: AOT Quality Indicator Indicator Number: AOT008

KPI Description
(title): Average Primary Organ Transplantation Wait Time
Domain Timeliness
Indicator Type Process
Average time an adult patient spends on the waiting list before receiving a primary
Definition:
organ transplant.
Numerator: Total number of days from registering in the transplant program till
day of operation for adult patients who had undergone primary transplant surgery
during the reporting period.

Denominator:
Total number of adult patients who have been on the waitlist and undergone
primary organ transplant surgery during the reporting period.

Note: Report the number of each transplant separately.

a) Kidney transplant from living donors
Calculation:
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

Denominator exclusion:
• Candidates who underwent living donor transplant but were never added
to the waiting list
• Candidates listed only for pancreatic islets are excluded from pancreas
reports.
Reporting
Semiannually
Frequency:
Unit of Measure: Average wait time for transplantation (days)
Scientific Registry of Transplant Recipients
International
https://www.srtr.org/about-the-data/technical-methods-for-the-program-
comparison if
specific-reports#tableb10
available
Technical Methods for the Program-Specific Reports (srtr.org)
Desired direction: Lower is better

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators

Type: AOT Quality Indicator Indicator Number: AOT009

KPI Description
(title): Primary Organ Transplantation Waitlist Mortality Rate
Domain Timeliness
Indicator Type Outcome
Deaths of adult patients on the primary organ transplantation waiting list .
Definition:
It reflects the program's ability to prioritize and allocate organs to patients in need
Numerator: The number of deaths that occurred during the reporting period
among adult patients on the primary organ transplantation waiting list.

Denominator: Total number of adult patient days for patients on the primary
organ transplantation waiting list during the reporting period.

Denominator Inclusion:
Patients on the waitlist are to be followed up from:
• Date of entry (at any time during the reporting period) into the transplant
program.
• Alive at the beginning of the reporting period (if already on the wait list)

Calculation: Patients on the waitlist are removed from the waitlist due to transplant, transfer,
recovery or death.

Denominator exclusion:
None

Note: Report the number of deaths and patient days for each transplant separately.
a) Kidney transplant from living donors
b) Kidney transplant from deceased donors
c) Combined pancreas kidney transplant
d) Heart Transplant
e) Lung Transplant

Reporting
Annually
Frequency:
Unit of Measure: Deaths per 1000 adult transplantation patient waitlist days
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773824
International
https://www.srtr.org/about-the-data/technical-methods-for-the-program-
comparison if
specific-reports#tableb5
available
Desired direction: Lower is better

Data sources and -Patient medical record

guidance: -Hospital administrative data

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 Adult Organ Transplant Service JAWDA Performance Indicators
Appendix: Transplantation complication codes
Diagnosis ICD-10 Description
Liver Transplant Complications
Ischemic biliary T86.49 Other complications of liver transplant
complications I74.8 Embolism and thrombosis of other arteries
due to hepatic Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
artery reaction of the patient, or of later complication, without mention of
thrombosis misadventure at the time of the procedure
Stenosis T86.49 Other complications of liver transplant
(hepatic artery) I70.8 Atherosclerosis of other arteries
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Stricture T86.49 Other complications of liver transplant
(hepatic artery) I70.8 Atherosclerosis of other arteries
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Bile Leak T86.49 Other complications of liver transplant
K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Bile collection T86.49 Other complications of liver transplant
(biloma) K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Biliary abscess T86.49 Other complications of liver transplant
K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Technical biliary complications
Anastomotic T86.49 Other complications of liver transplant
stricture K83.1 Obstruction of bile duct
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Anastomotic T86.49 Other complications of liver transplant
leak K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Cut surface T86.49 Other complications of liver transplant
leak1 K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
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 Adult Organ Transplant Service JAWDA Performance Indicators
Missed T86.49 Other complications of liver transplant
segmental duct K83.8 Other specified diseases of biliary tract
leak1 Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Kinking T86.49 Other complications of liver transplant
K83.8 Other specified diseases of biliary tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Cystic duct T86.49 Other complications of liver transplant
mucocele K82.8 Other specified diseases of gallbladder
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Ischemic-type biliary lesions
Ischemia- T86.49 Other complications of liver transplant
reperfusion K83.8 Other specified diseases of biliary tract
injury related Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Immunological2 K83.8 Other specified diseases of biliary tract
Idiopathic K83.8 Other specified diseases of biliary tract
Infectious biliary T86.43 Liver transplant infection
complications/c K83.09 Other cholangitis
holangitis Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure

Heart Transplant Complications

PGD-LV, for PGD affecting the left ventricle with T86.98 Other complications of heart transplant
extracorporeal short-term mechanical circulatory Y83.0 Surgical operation with transplant of
support whole organ as the cause of abnormal
reaction of the patient, or of later
complication, without mention of
misadventure at the time of the procedure
Biventricular failure with extracorporeal short- T86.22 Heart transplant failure
term mechanical circulatory support I50.82 Biventricular heart failure
Y83.0 Surgical operation with transplant of
whole organ as the cause of abnormal
reaction of the patient, or of later
complication, without mention of
misadventure at the time of the procedure
PGD-RV for isolated right ventricular involvement T86.98 Other complications of heart transplant
with right-sided short-term VAD (RVAD) or right Y83.0 Surgical operation with transplant of
heart catheter measured haemodynamics in whole organ as the cause of abnormal
keeping with isolated right-sided dysfunction reaction of the patient, or of later
(RAP > 15 mmHg, PCWP < 15 mmHg, CI < 2.0 complication, without mention of
L/min/m2, TPG < 15 mmHg and/or pulmonary misadventure at the time of the procedure
artery systolic pressure < 50 mmHg)

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 Adult Organ Transplant Service JAWDA Performance Indicators
Lung Transplant Complications
Bronchial T86.818 Other complications of lung transplant
dehiscence J98.09 Other diseases of bronchus, not elsewhere classified
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Bronchial T86.818 Other complications of lung transplant
anastomotic J98.09 Other diseases of bronchus, not elsewhere classified
stenosis Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Non- T86.818 Other complications of lung transplant
anastomotic J98.09 Other diseases of bronchus, not elsewhere classified
stenosis Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Tracheobroncho T86.818 Other complications of lung transplant
malacia (TBM) J39.8 Other specified diseases of upper respiratory tract
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Vascular Complications of Lung Transplant
Pulmonary T86.818 Other complications of lung transplant
embolism I26.99 Other pulmonary embolism without acute cor pulmonale
Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Arterial stenosis T86.818 Other complications of lung transplant
(unspecified I77.1 Stricture of artery
site) Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Venous stenosis T86.818 Other complications of lung transplant
(unspecified I87.1 Compression of vein
site) Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Venous T86.818 Other complications of lung transplant
thrombosis I82.90 Acute embolism and thrombosis of unspecified vein
(unspecified Y83.0 Surgical operation with transplant of whole organ as the cause of abnormal
site) reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure

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