The influence of clinical variables on hospital costs after orthotopic liver transplantation

Abstract

Length of stay is the most important determinant of costs after OLTx. Rational strategies to design cost-effective protocols after OLTx will require further studies to truly define the cost of various morbidities and outcomes after OLTx.

Intraoperative blood transfusion requirement is the main determinant of early surgical re-intervention after orthotopic liver transplantation

“…This study clearly indicates the relation between intraoperative blood loss, surgical re-intervention during the in-hospital stay after liver transplantation, and a prolonged in-hospital stay. The requirement for additional operating procedures after liver transplantation is associated with high costs [24], and length of in-hospital stay has been shown to be the most important determinant of costs after liver transplantation [25]. As we found surgical re-intervention to be mainly related to more intraoperative blood loss and a prolonged inhospital stay, they were associated with higher costs.…”

Model for end-stage liver disease and Child-Turcotte-Pugh score as predictors of pretransplantation disease severity, posttransplantation outcome, and resource utilization in United Network for Organ Sharing status 2A patients

“…10,11 We analyzed a cohort that traditionally incurs higher charges and uses more resources by using resource variables that account for most of the charges incurred during OLT. [12][13][14] Room and care charges, which are directly related to LOS, and treatments, including operating room charges and blood product use, account for up to two Our study using patients undergoing OLT at a single center eliminated other variations in clinical practices across transplant centers that may affect resource utilization, such as differences in surgical techniques, immunosuppression protocols, clinical expertise of transplant professionals, and immediate post-OLT management, as well as differences in severity of disease caused by regional differences in organ procurement and allocation. 14 Also, our sample was accrued over a relatively short period of 2 years, minimizing the role of improvements in peri-OLT management in results observed.…”

An efficacy and cost-effectiveness analysis of combination hepatitis B immune globulin and lamivudine to prevent recurrent hepatitis B after orthotopic liver transplantation compared with hepatitis B immune globulin monotherapy

“…Second, the costs related to retransplantation used in our analysis were the costs for an initial hepatic transplantation, yet several investigators have shown that hepatic retransplantation incurs costs that are significantly greater than for initial transplantation. [27][28][29] Specifically, Whiting et al 29 found in a recent analysis that the median cost of hepatic retransplantation is $97,000 more than initial OLT and is significantly correlated with increased cost on multivariate analysis. Markmann et al 27 found that longer hospital and intensive care unit stays for retransplantation patients contributed to a 170% increase in hospital charges for retransplantation patients.…”