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Hospital Resource Use with Donation after Cardiac Death Allografts in Liver Transplantation: A Matched Controlled Analysis from 2007 to 2011.
- Source :
-
Journal of the American College of Surgeons [J Am Coll Surg] 2015 May; Vol. 220 (5), pp. 951-8. Date of Electronic Publication: 2015 Feb 11. - Publication Year :
- 2015
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Abstract
- Background: Although donation after cardiac death (DCD) liver allografts have been used to expand the donor pool, concerns exist regarding primary nonfunction and biliary complications. Our aim was to compare resource use and outcomes of DCD allografts with donation after brain death (DBD) liver allografts.<br />Study Design: Using a linkage between the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified 11,856 patients who underwent deceased donor liver transplantation (LT) from 2007 to 2011. Patients were divided into 2 cohorts based on type of allograft (DCD vs DBD). Matched pair analysis (n = 613 in each group) was used to compare outcomes of the 2 donor types.<br />Results: Donation after cardiac death allografts comprised 5.2% (n = 613) of all LTs in the studied cohort; DCD allograft recipients were healthier and had lower median Model of End-Stage Liver Disease (MELD) score (17 vs 19; p < 0.0001). Post LT, there was no significant difference in length of stay, perioperative mortality, and discharge to home rates. However, DCD allografts were associated with higher direct cost ($110,414 vs $99,543; p < 0.0001) and 30-day readmission rates (46.4% vs 37.1%; p < 0.0001). Matched analysis revealed that DCD allografts were associated with higher direct cost, readmission rates, and inferior graft survival.<br />Conclusions: While confirming the previous reports of inferior graft survival associated with DCD allografts, this is the first national report to show increased financial and resource use associated with DCD compared with DBD allografts in a matched recipient cohort.<br /> (Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Allografts economics
End Stage Liver Disease economics
Female
Graft Survival
Humans
Liver Transplantation methods
Male
Matched-Pair Analysis
Middle Aged
Patient Readmission statistics & numerical data
Retrospective Studies
Tissue and Organ Procurement
Treatment Outcome
United States
Young Adult
Brain Death
Death
End Stage Liver Disease surgery
Hospital Costs statistics & numerical data
Liver Transplantation economics
Patient Readmission economics
Tissue Donors
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1190
- Volume :
- 220
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 25840540
- Full Text :
- https://doi.org/10.1016/j.jamcollsurg.2015.01.052