Is the Cost of Adult Living Donor Liver Transplantation Higher Than Deceased Donor Liver Transplantation?

✍ Scribed by Mark W. Russo; Robert S. Brown Jr.

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 56 KB
• Volume: 10
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20102

✦ Synopsis

Background. An important long-term consideration for living-donor liver transplantation (LDLT) is the expense compared with cadaveric-liver transplantation. LDLT is a more complex procedure than cadaveric transplantation and the cost of donor evaluation, donor surgery, and postoperative donor care must be included in a cost analysis for LDLT. In this study, we compare the comprehensive cost of LDLT with that of cadaveric-liver transplantation. Methods. All costs for medical services provided at our institution were recorded for 24 LDLT and 43 cadaveric recipients with greater than 1 year follow-up transplanted between August 1997 and April 2000. The donor costs include donors evaluated and rejected, donors evaluated and accepted, donor right hepatectomy costs, and donor follow-up costs (365 days postdonation). LDLT and cadaveric recipient costs include medical care 90 days pre-LDLT, recipient transplant costs, and recipient follow-up costs (365 days posttransplant) including retransplantation. Cost is expressed as an arbitrary cost unit (CU) that is a value between $500 to $1,500. Results. Total LDLT costs (evaluations of rejected donors ؉ evaluations of accepted donors ؉ donor hepatectomy ؉ donor follow-up care for 1 year ؉ pretransplant recipient care [90 days pretransplant] ؉ recipient transplantation ؉ recipient 1-year posttransplant care)‫؍‬ 162.7 CU. Total mean cadaveric transplant costs (pretransplant recipient care [90 days pretransplant] ؉ recipient transplantation [including organ acquisition cost] ؉ recipient 1-year posttransplant care)‫5.431؍‬ CU, (P ‫؍‬ ns). Conclusions. The total comprehensive cost of LDLT is 21% higher than cadaveric transplantation, although this difference is not significant.