Costs and Outcomes of Liver Transplantation in Adults

Rufat, Pierre; Fourquet, Florence; Conti, Filoména; Galès, Catherine Le; Houssin, D; Coste, Joël

doi:10.1097/00007890-199907150-00015

Cited by 28 publications

(13 citation statements)

References 30 publications

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“…Several studies have reported the financial costs of DDLT (10,11), but the data regarding the financial burden associated with LDLT are limited by small patient numbers (12 …”

Section: the Impact Of Ldlt On Patient Outcomes Remains Controversimentioning

confidence: 99%

Resource Utilization of Living Donor Versus Deceased Donor Liver Transplantation Is Similar at an Experienced Transplant Center

Lai¹,

Pichardo

Emond

et al. 2009

American Journal of Transplantation

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Although living donor liver transplantation (LDLT) has been shown to decrease waiting-list mortality, little is known of its financial impact relative to deceased donor liver transplantation (DDLT). We performed a retrospective cohort study of the comprehensive resource utilization, using financial charges as a surrogate measure-from the pretransplant through the posttransplant periods-of 489 adult liver transplants (LDLT n = 86; DDLT n = 403) between January 1, 2000, through December 31, 2006, at a single center with substantial experience in LDLT. Baseline characteristics differed between LDLT versus DDLT with regards to age at transplantation (p = 0.02), male gender (p < 0.01), percentage Caucasians (p < 0.01) and transplant model for end-stage liver disease (MELD) score (p < 0.01). In univariate analysis, there was a trend toward decreased total transplant charges with LDLT (p = 0.06), despite increased surgical charges associated with LDLT (p < 0.01). After adjustment for the covariates that were associated with financial charges, there was no significant difference in total transplant charges (p = 0.82). MELD score at transplant was the strongest driver of resource utilization. We conclude that at an experienced transplant center, LDLT imposes a similar overall financial burden than DDLT, despite the increased complexity of living donor surgery and the addition of the costs of the living donor. We speculate that LDLT optimizes transplantation by transplanting healthier and younger recipients.

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“…Several studies have reported the financial costs of DDLT (10,11), but the data regarding the financial burden associated with LDLT are limited by small patient numbers (12 …”

Section: the Impact Of Ldlt On Patient Outcomes Remains Controversimentioning

confidence: 99%

Resource Utilization of Living Donor Versus Deceased Donor Liver Transplantation Is Similar at an Experienced Transplant Center

Lai¹,

Pichardo

Emond

et al. 2009

American Journal of Transplantation

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“…3 Moreover, the economics, social burden, and ethical considerations of maintaining patients on waiting lists should also be taken into consideration. 4 Over the years, many clinical and biochemical parameters have been suggested in order to more accurately predict the prognosis of cirrhotic patients and correctly assess their short and medium term survival. The Child-Pugh score is still considered the cornerstone in the prognostic evaluation of cirrhotic patients although it was formulated more than 30 years ago.…”

mentioning

confidence: 99%

MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study

Botta

Giannini

Romagnoli

et al. 2003

Gut

310

212

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Background: Indices for predicting survival are essential for assessing prognosis and assigning priority for liver transplantation in patients with liver cirrhosis. The model for end stage liver disease (MELD) has been proposed as a tool to predict mortality risk in cirrhotic patients. However, this model has not been validated beyond its original setting. Aim: To evaluate the short and medium term survival prognosis of a European series of cirrhotic patients by means of MELD compared with the Child-Pugh score. We also assessed correlations between the MELD scoring system and the degree of impairment of liver function, as evaluated by the monoethylglycinexylidide (MEGX) test. Patients and methods: We retrospectively evaluated survival of a cohort of 129 cirrhotic patients with a follow up period of at least one year. The Child-Pugh score was calculated and the MELD score was computed according to the original formula for each patient. All patients had undergone a MEGX test. Multivariate analysis was performed on all variables to identify the parameters independently associated with one year and six month survival. MELD values were correlated with both Child-Pugh scores and MEGX test results. Results: Thirty one patients died within the first year of follow up. Child-Pugh and MELD scores, and MEGX serum levels were significantly different among patients who survived and those who died. Serum creatinine, international normalised ratio, and MEGX 60 were independently associated with six month mortality while the same variables and the presence of ascites were associated with one year mortality. MELD scores showed significant correlations with both MEGX values and Child-Pugh scores.

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“…Retransplantation is known to have a significant impact on cost of care of transplant recipients. 28,35,36 However, in this series, retransplantation was not identified as a predictor of cost. A significant difference in cost of transplantation and care in the first year persisted after the 2 patients (1 LDLT and 1 CDLT) who were given retransplantation during their initial transplant visit are excluded from the analysis.…”

Section: Discussionmentioning

confidence: 60%

Outcome after pediatric liver transplantation impact of living donor transplantation on cost

Cole

Bucuvalas

Hornung

et al. 2004

The Journal of Pediatrics

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Costs and Outcomes of Liver Transplantation in Adults

Cited by 28 publications

References 30 publications

Resource Utilization of Living Donor Versus Deceased Donor Liver Transplantation Is Similar at an Experienced Transplant Center

Resource Utilization of Living Donor Versus Deceased Donor Liver Transplantation Is Similar at an Experienced Transplant Center

MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study

Outcome after pediatric liver transplantation impact of living donor transplantation on cost

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