Healthcare Resource Utilization After Living Liver Donation: A Retrospective Case–Control Study

Abstract

Background. Living liver donation is generally considered safe, but donors may experience short- or long-term complications. The purpose of this study was to assess healthcare resource utilization after liver donation in living liver donors in comparison with the general population. Methods. Outpatient or emergency department visits and hospital admissions were compared between living liver donors who underwent hepatic resection for living liver donation between 2004 and 2018 and the matched general population. Healthcare resource utilization data for 5 y after liver donation were collected from the National Health Insurance Service database. For every living liver donor, 4 individually matched nondonors were selected from the National Health Insurance Service database using age, sex, preexisting comorbidities, and previous healthcare utilization history. Results. A total of 1886 living liver donors and 7309 nondonors were included. In the first year after donation, living liver donors required more outpatient department visits (7 [4–13] versus 3 [1–7], P < 0.001) and more emergency department visits (13.33% versus 0.15%, P < 0.001) compared with matched nondonors. A similar trend persisted for 5 y after donation. The number of hospital admissions of living liver donors was higher for up to 2 y after donation with longer hospital length of stay (13.0 [10.5–16.0] d versus 5.0 [3.0–9.0] d, P < 0.0001). Conclusions. Healthcare resource utilization in living liver donors for 5 y after donation was higher compared with matched nondonors. The higher healthcare resource demand may be related to postoperative complications or lowered threshold for healthcare resource utilization after donation.

Being Well Informed Is Critical to Informed Consent for Living Liver Donors

“…Reports from the adult-to-adult living liver donor study study have provided insight into 29 predefined donor complications collected from the experience of 760 living liver donors with a median follow-up of 3.4 y in the retrospective cohort of that study but also included donors who had as much as 10 y of follow-up. 8 The report by Im et al, 9 in this issue of Transplantation, seeks to add additional insight into the health experience of living liver donors. The authors were able to identify 1886 living liver donors from the Korean National Health Service database and obtain information regarding healthcare utilization by these donors during a year before their donation to assess baseline healthcare utilization and then over the 5 y following their donation surgery.…”

“…The report by Im et al, 9 in this issue of Transplantation , seeks to add additional insight into the health experience of living liver donors. The authors were able to identify 1886 living liver donors from the Korean National Health Service database and obtain information regarding healthcare utilization by these donors during a year before their donation to assess baseline healthcare utilization and then over the 5 y following their donation surgery.…”