Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Transplant Toxicities

The impact of center accreditation on hematopoietic cell transplantation (HCT)

Subjects

Abstract

There are two voluntary center-accrediting organizations in the USA, the Foundation for the Accreditation of Cellular Therapy (FACT) and core Clinical Trial Network (CTN) certification, that are thought to improve and ensure hematopoietic cell transplantation (HCT) center quality care and certify clinical excellence. We sought to observe whether there are differences in outcomes between HLA-matched and -mismatched HCT by CTN and FACT status. Using the 2008–2010 Center for International Blood & Marrow Transplant Research data we created three center categories: non-FACT centers (24 centers), FACT-only certified centers (106 centers) and FACT and core clinical trial network (FACT/CTN) certified centers (32 centers). We identified patient characteristics within these centers and the relationship between FACT certification and survival. Our cohort consisted of 12 993 transplants conducted in 162 centers. After adjusting for patient and center characteristics we found that FACT/CTN centers had consistently superior results relative to non-FACT and FACT-only centers (P<0.05) especially for more complex HCT. However, non-FACT centers were comparable to FACT-only centers for matched related and unrelated patients. Although FACT status is an important standard of quality control that begins to define improved OS, our results indicate that FACT status alone is not an indicator for superior outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Petersdorf EW, Anasetti C, Martin PJ, Gooley T, Radich J, Malkki M et al. Limits of HLA mismatching in unrelated hematopoietic cell transplantation. Blood 2004; 104: 2976–2980.

    Article  CAS  PubMed  Google Scholar 

  2. Morishima Y, Sasazuki T, Inoko H, Juji T, Akaza T, Yamamoto K et al. The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B, and HLA-DR matched unrelated donors. Blood 2002; 99: 4200–4206.

    Article  CAS  PubMed  Google Scholar 

  3. National Marrow Donor Program. Be the Match. HLA matching: finding the best donor or cord blood unit. http://marrow.org (accessed 30 April 2013).

  4. Petersdorf EW, Gooley TA, Anasetti C, Martin PJ, Smith AG, Mickelson EM et al. Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient. Blood 1998; 92: 3515–3520.

    CAS  PubMed  Google Scholar 

  5. Flomenberg N, Baxter-Lowe LA, Confer D, Fernandez-Vina M, Filipovich A, Horowitz M et al. Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome. Blood 2004; 104: 1923–1930.

    Article  CAS  PubMed  Google Scholar 

  6. The Foundation for the Accreditation of Hematopoietic Cellular Therapy. Expectations of FACT inspectors. http://marrow.org (accessed 30 April 2013).

  7. Blue Cross Blue Shield Association. Blue distinction centers for transplants. http://www.bcbs.com/why-bcbs/blue-distinction/blue-distinction-transplants/BMT_MidLevelCriteria.pdf (accessed 30 April 2013).

  8. Loberiza FR Jr, Zhang MJ, Lee SJ, Klein JP, LeMaistre CF, Serna DS et al. Association of transplant center and physician factors on mortality after Hematopoietic Cell Transplantation in the United States. Blood 2005; 105: 2979–2987.

    Article  CAS  PubMed  Google Scholar 

  9. Birkmeyer NJ, Goodney PP, Stukel TA, Hillner BE, Birkmeyer JD . Do cancer centers designated by the National Cancer Institute have better surgical outcomes? Cancer 2005; 103: 435–441.

    Article  PubMed  Google Scholar 

  10. Meguid RA, Brooke BS, Chang DC, Sherwood JT, Brock MV, Yang SC . Are surgical outcomes for lung cancer resections improved at teaching hospitals? Ann Thoracic Surg 2008; 85: 1015–1025.

    Article  Google Scholar 

  11. Allison JJ, Kiefe CI, Weissman NW, Person SD, Rousculp M, Canto JG et al. Relationship of hospital teaching status with quality of care and mortality for Medicare patients with acute MI. JAMA 2000; 284: 1256–1262.

    Article  CAS  PubMed  Google Scholar 

  12. Ayanian JZ, Weissman JS, Chasan-Taber S, Epstein AM . Quality of care for two common illnesses in teaching and nonteaching hospitals. Health Aff (Millwood) 1998; 17: 194–205.

    Article  CAS  Google Scholar 

  13. Keeler EB, Rubenstein LV, Kahn KL, Draper D, Harrison ER, McGinty MJ et al. Hospital characteristics and quality of care. JAMA 1992; 268: 1709–1714.

    Article  CAS  PubMed  Google Scholar 

  14. Kuhn EM, Hartz AJ, Krakauer H, Bailey RC, Rimm AA . The relationship of hospital ownership and teaching status to 30- and 180-day adjusted mortality rates. Med Care 1994; 32: 1098–1108.

    Article  CAS  PubMed  Google Scholar 

  15. Gratwohl A, Brand R, Niederwieser D, Baldomero H, Chabannon C, Cornelissen J . Introduction of a quality management system and outcome after hematopoietic stem-cell transplantation. J Clin Oncol 2011; 29: 1980–1986.

    Article  PubMed  Google Scholar 

  16. Rosenthal GE, Harper DL, Quinn LM, Cooper GS . Severity-adjusted mortality and length of stay in teaching and nonteaching hospitals: results of a regional study. JAMA 1997; 278: 485–490.

    Article  CAS  PubMed  Google Scholar 

  17. Zimmerman JE, Shortell SM, Knaus WA, Roussear DM, Wagner DP, Gillies RR et al. Value and cost of teaching hospitals: a prospective, multicenter, inception cohort study. Crit Care Med 1993; 21: 1432–1442.

    Article  CAS  PubMed  Google Scholar 

  18. Hartz AJ, Krakauer H, Kuhn EM, Young M, Jacobsen SJ, Gay G et al. Hospital characteristics and mortality rates. New Engl J Med 1989; 321: 1720–1725.

    Article  CAS  PubMed  Google Scholar 

  19. Kuhn EM, Hartz AJ, Gottlieb MS, Rimm AA . The relationship of hospital characteristics and the results of peer review in six large states. Med Care 1991; 29: 1028–1038.

    Article  CAS  PubMed  Google Scholar 

  20. Taylor DH, Whellan DJ, Sloan FA . Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries. New Engl J Med 1999; 340: 293–299.

    Article  PubMed  Google Scholar 

  21. Majhail NS, Murphy E . Allogenic transplant physician and center capacity in the United States. Blood 2011; 17: 956–961.

    Google Scholar 

  22. Loberiza FR Jr, Serna DS, Horowitz MM, Rizzo JD . Transplant center characteristics and clinical outcomes after hematopoietic stem cell transplantation: What do we know? Bone Marrow Transplant 2003; 31: 417–421.

    Article  PubMed  Google Scholar 

  23. National Cancer Institute. Blood and Marrow Clinical Trials Network. Partnerships and Collaborations. http://dctd.cancer.gov/ProgramPages/ctep/partnerships_bmtctn.htm (accessed 30 April 2013).

  24. Center for International Blood and Marrow Transplant Research (CIBMTR)Karnofsky/Lansky Performance Score. http://www.cibmtr.org/DataManagement/TrainingReference/Manuals/DataManagement/Documents/appendix-l.pdf (accessed 23 October 2014).

  25. Center for International Blood and Marrow Transplant Research. CIBMTR data management and training. http://www.cibmtr.org/DataManagement/TrainingReference/Manuals/DataManagement/Documents/appendix-l.pdf (accessed 30 April 2013).

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S Marmor.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marmor, S., Begun, J., Abraham, J. et al. The impact of center accreditation on hematopoietic cell transplantation (HCT). Bone Marrow Transplant 50, 87–94 (2015). https://doi.org/10.1038/bmt.2014.219

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2014.219

This article is cited by

Search

Quick links