Liise K. Kayler, Kusum Tom, Paolo Fontes, Igor Dvorchik, Amadeo Marcos. Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Background: Liver transplantation is one of the most costly surgical procedures performed today. Live-donor liver transplantation (LDLT) may be more financially advantageous over deceased-donor liver transplantation (DDLT) due to the opportunity to select patients who are less ill and to operate in an elective manner; however, few studies have addressed this issue.

Methods: Between January 2001 and December 2004, 833 consecutive adult liver transplants (LDLT 74, DDLT 758) were analyzed. Charges were recorded for the following time periods: (1) pretransplant, 90 days before transplantation, (2) the transplant hospitalization, and (3) posttransplant , 365 days after the transplant hospitalization. Charges were expressed as an arbitrary charge unit (ChU) that is a value between $5,000 and $15,000.

Results: Compared with DDLT, the average ChU for LDLT was threefold lower for pretransplant care (p<0.0001), 22% lower for the transplant admission (p=0.0316), and 8% lower for post-hospitalization medical care (p=0.2113). Baseline characteristics indicated a healthier status of the LDLT group who exhibited significantly lower MELD scores ( p<0.0001), shorter average 90-day pretransplant hospital length of stays (p=0.0091), shorter average time on the liver transplant waiting list ( p<0.0001), and proportionately less requirement for pretransplant mechanical ventilation (p=0.0320], compared to DDLT recipients.

Conclusion: The magnitude of the cost advantage for living- over deceased- donor transplantation depends greatly on recipient health.

Date: Thursday, June 21, 2007
Session Info: Living Donor (2:30 PM-4:00 PM)
Presentation Time: 03:30 PM
Room: Gavea B, 5th Floor