The Increased Costs of Donation After Cardiac Death Liver Transplantation: Caveat Emptor

摘要: Objective: To determine the effect of donation after cardiac death (DCD) livers on post-transplantation costs. Background: DCD are increasingly being used to expand donor pool despite higher complication rates. Although complications liver transplantation have profound financial implications, costs has not been studied. Methods: We estimated direct medical care based inpatient and outpatient hospital for 28 198 brain (DBD) recipients. Organ acquisition physician were excluded. Results: Donor recipient demographics comparable DBD transplants. One-year, recipients (124.9% costs, P = 0.04). remained (125.2% 0.009) adjusting characteristics. Furthermore, 30% than pre-transplantation (P 0.02). Biliary (DCD 58% vs. 21%; < 0.001) and, specifically, ischemic cholangiopathy 44% 1.6%; occurred more frequently transplantation. Moreover, underwent retransplantation often 21% 7.1%, One-year increased with or by 53% 0.01) 107% 0.001), respectively. However, continued be when retransplanted patients excluded (120% Conclusions: Higher rates graft failure biliary translate into markedly These important implications should considered in decisions regarding use livers.