Hospital Resource Use with Donation after Cardiac Death Allografts in Liver Transplantation: A Matched Controlled Analysis from 2007 to 2011 - 22/04/15
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.
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.
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.
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.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : CDB/RM, CIT, DBD, DCD, DRI, LT, MELD, SRTR, UHC
Plan
Disclosure Information: Nothing to disclose. |
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Support: The Health Resources and Services Administration Scientific Registry of Transplant Recipients (SRTR) Project Officer and the SRTR Technical Advisory Committee approved the linkage of the two datasets. The data reported here have been supplied by the Minneapolis Medical Research Foundation as the contractor for the SRTR. |
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Disclaimer: The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. |
Vol 220 - N° 5
P. 951-958 - mai 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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