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Enhanced recovery in liver transplantation: A value-based approach to complex surgical care, but compliance is missing

  • Raffaele Brustia
    Correspondence
    Corresponding author.
    Affiliations
    Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, France; INSERM U955, Team “Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers,” Créteil, France
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  • Daniele Sommacale
    Affiliations
    Paris Est Créteil University, UPEC, Créteil, France; INSERM U955, Team “Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers,” Créteil, France; Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreatic-Biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France
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  • Olivier Scatton
    Affiliations
    Service de chirurgie digestive et hépato-bilio-pancréatique, transplantation hépatique, Centre Hospitalo-Universitaire Pitié-Salpêtriere, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France. Centre de Recherche Saint-Antoine, Unité Mixte de Recherche S-938, Institute of Cardiometabolism and Nutrition, Sorbonne Université, Institut national de la santé et de la recherche médicale, Paris, France
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      We read with interest the nicely designed before–after study from Feizpour et al,
      • Feizpour C.A.
      • Patel M.S.
      • Syed M.A.
      • et al.
      Enhanced recovery in liver transplantation: a value-based approach to complex surgical care.
      which focused on the impact of an enhanced recovery pathway (ERP) on liver transplantation (LT). In 3 years, the introduction of a 19 elements–based ERP program was associated with a shorter hospital stay, reduced rate of postoperative complications, and lower median direct cost per case. Despite the recently published recommendations of the ERAS society on LT,
      • Brustia R.
      • Monsel A.
      • Skurzak S.
      • et al.
      Guidelines for perioperative care for liver transplantation: Enhanced Recovery After Surgery (ERAS) Society recommendations.
      the introduction of such a multidisciplinary program in the complex care setting of LT is still new and remarkable, and the authors should be commended for their effort.
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      References

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        • et al.
        Enhanced recovery in liver transplantation: a value-based approach to complex surgical care.
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        Guidelines for perioperative care for liver transplantation: Enhanced Recovery After Surgery (ERAS) Society recommendations.
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