Median Time From Organ Transplantation to Hospital Discharge

The median number of transplant patients’ total days stayed between transplantation and discharge.

Unit of analysis: Hospitalization

This indicator is calculated for hospitalizations where at least one transplantation procedure occurred and the first transplantation procedure in the hospitalization was of a kidney, kidney–liver, kidney–pancreas, liver, heart, lung or islets.

Hospitalization data is from the Hospital Morbidity Database (HMDB) and is supplemented with data from the Canadian Organ Replacement Register (CORR) as follows:

1. Organ transplants in the HMDB have code 1.GR.85.^^, 1.GT.85.^^, 1.HY.85.^^, 1.HZ.85.^^, 1.NK.85.^^, 1.NP.85.^^, 1.OA.85.^^, 1.OJ.85.^^, 1.OK.85.^^ or 1.PC.85.^^. Only those where the status attribute code is not A (abandoned) are considered.
2. Transplantation episodes are linked to CORR data using the patient’s health card number and surgery date (plus or minus 1 day). In the case of duplicate linkages, the best match is chosen using the following priorities:
   1. If available, choose the record where the CORR surgery date matches the HMDB episode start date.
   2. Otherwise, choose the record where the CORR surgery date matches the HMDB episode end date.
   3. Otherwise, choose the record with the lowest CORR recipient treatment ID.
3. If a CORR record links, information on organs transplanted comes from CORR. Otherwise, information comes from the HMDB.

Transplanted organs are defined as the following:

1. Kidney: CORR organ type code beginning with 1; HMDB CCI code 1.PC.85.^^, 1.OK.85.XU-XX-K or 1.OK.85.XV-XX-K
2. Liver: CORR organ type code beginning with 2; HMDB CCI code 1.OA.85.^^
3. Heart: CORR organ type code 30; HMDB CCI code 1.HZ.85.^^
4. Lung: CORR organ type code beginning with 4; HMDB CCI code 1.GR.85.^^ or 1.GT.85.^^
5. Islets: CORR organ type code 52; HMDB CCI code 1.OJ.85.^^
6. Kidney–pancreas: For a single treatment, CORR organ type codes beginning with 1 and with 5, excluding 52; HMDB CCI code 1.OK.85.XU-XX-K or 1.OK.85.XV-XX-K; or for a single surgical episode, HMDB CCI codes 1.OK.85.^^ and 1.PC.85.^^
7. Kidney–liver: For a single treatment, CORR organ type codes meeting the above kidney and liver criteria; or for a single surgical episode, HMDB CCI codes 1.PC.85.^^ and 1.OA.85.^^

For kidney and liver transplants, results are shown separately for first and second transplants. For records that link to CORR, the graft number determines this. For records that do not link to CORR, a transplant was considered a first transplant if the same patient did not have a previous transplant of the same organ reported in the HMDB since 2013. Records that did not link to CORR were not assigned to the retransplantation category.

Hospitalizations are excluded from analysis if they meet any of the following criteria:

1. Hospitalizations with an invalid discharge date
2. For organs other than kidneys and livers, the first transplantation procedure in the hospitalization was an organ retransplantation:
   • CORR: Graft number is greater than 1
   • HMDB: A previous transplantation of the same organ had occurred in the same patient since 2013
3. Invalid health card number or code for province issuing health card number 
4. Hospitalizations where the first transplantation procedure that occurred involved transplantation of multiple organs, aside from a kidney–liver or kidney–pancreas transplant (transplants that involve additional organs to a kidney–liver or kidney–pancreas transplant are excluded)

These are defined as

• Any transplant where a combination transplant occurred, based on the codes outlined in the inclusion criteria
• Any transplant intervention with HMDB CCI code 1.HY.85.^^ (heart–lung transplant) or 1.OA.85.VC-XX-K (multiple abdominal organs transplanted)
• Any transplant where a linked CORR record includes the organ type code 43, 60 or 90

Not applicable

Not applicable