{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:17:06Z","timestamp":1792819026577,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Enhanced recovery after surgery protocols have been shown to reduce length of stay in transplant patients.\u00a0The purpose of our study was to evaluate the impact of a standardized protocol in liver transplant recipients (LTR) on length of stay (LOS) and delirium during the index hospitalization post\u2010LT. Elements of the protocol included reduced intraoperative corticosteroids (from methylprednisolone 1000 to 250\u00a0mg), conversion of steroid taper to be administered once\u2010daily instead of BID, optimal end\u2010of\u2010case intraoperative extubation, multimodal analgesia, early removal of surgical drains, implementation of dietary and physical therapy plans and education for multidisciplinary providers and patients about expected LOS. The primary outcome was post\u2010LT LOS. Secondary outcomes included incidence of delirium, ICU LOS, rejection at 60 days and readmission within 30 days of discharge. A total of 125 LTRs were included. Baseline characteristics were similar between groups. The median LOS was 12 days (IQR, 9\u201319) and 10 days (IQR, 8\u201315) in the pre\u2010 and post\u2010implementation groups, respectively (<jats:italic>p<\/jats:italic> = 0.025). ICU LOS was 2.9 (IQR, 2.1\u20134) and 2.7 (IQR, 1.9\u20133.7) in the pre\u2010 and post\u2010implementation groups, respectively (<jats:italic>p<\/jats:italic> = 0.525). In the pre\u2010 and post\u2010implementation groups, the incidence of delirium was 17 (25.8%) and 5 (8.6%), respectively (<jats:italic>p<\/jats:italic> = 0.013). The incidence of treated rejection at 60 days was 3% (0.0\u201310.1) and 5.2% (2.9\u201315.2) in the pre\u2010 and post\u2010implementation groups, respectively (<jats:italic>p<\/jats:italic> = 0.550).\u00a0Implementation of a Fast Track protocol in a high acuity LTR was feasible and safe and was associated with a reduction in LOS.<\/jats:p>","DOI":"10.1111\/ctr.70111","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T12:20:26Z","timestamp":1739881226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Liver Transplant Fast\u2010Track With an Emphasis on Reduced Delirium: A Multidisciplinary Approach to Reducing Length of Stay"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5450-3995","authenticated-orcid":false,"given":"David M.","family":"Salerno","sequence":"first","affiliation":[{"name":"Department of Pharmacy NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Genovese","sequence":"additional","affiliation":[{"name":"Department of Surgery NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Jesudian","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Surgery NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashal","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry New York\u2010Presbyterian\/Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Samstein","sequence":"additional","affiliation":[{"name":"Department of Surgery Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3244-4696","authenticated-orcid":false,"given":"Danielle","family":"Brandman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201076396\u20105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12796"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.07.001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010021\u201005963\u20102"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq\u20102022\u2010002149"},{"issue":"1","key":"e_1_2_9_7_1","first-page":"25","article-title":"Post\u2010Liver Transplant Delirium Increases Mortality and Length of Stay","volume":"17","author":"Oliver N.","year":"2017","journal-title":"Ochsner Journal"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1229990"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.12788\/fp.0003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540\u2010022\u201003049\u20104"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2017.11.010"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01062461"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T09:51:23Z","timestamp":1747907483000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/ctr.70111"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70111","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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