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Is the Cost of Adult Living Donor Liver Transplantation Higher Than Deceased Donor Liver Transplantation?
Author(s) -
Russo Mark W.,
Brown Robert S.
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20102
Subject(s) - medicine , liver transplantation , transplantation , cadaveric spasm , surgery , living donor liver transplantation , hepatectomy , resection
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)=134.5 CU, ( P = ns) Conclusions The total comprehensive cost of LDLT is 21% higher than cadaveric transplantation, although this difference is not significant. (Transplantation 2003;75:473–476.)