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• W2024129191 abstract "P564 Aim: The recent change to the MELD system for liver transplantation was designed to better prioritize liver transplant candidates. In general, the cost of care and resource use increase as severity of illness increases. Therefore we determined if deceased donor liver transplant costs and resource use have changed since the implementation of the MELD system. Methods: We compared all hospital direct costs from one month prior to transplant to one year after transplant for 41 cases transplanted in the year preceding MELD (PRE) with 34 cases transplanted after MELD (POST) implementation. Results: Median calculated MELD score for PRE patients was 17.0, and 23.5 for POST recipients (P=0.023). There were 9 cases of hepatocellular cancer (HCC) in the PRE and 10 cases in the POST eras (P=0.460). Overall, median direct cost and total LOS at one year were not different (PRE $93,156 vs. POST $76,137, P=0.312 and PRE 39 days vs. POST 29 days, P=0.363 respectively). There was a trend towards less cost and LOS in the POST era. Compared with the PRE period, POST recipients required fewer surgical procedures (2.40 vs. 1.94, P=0.074) and had lower median blood bank ($24,422 vs. $13,714, P=0.004) and pharmacy cost ($16,726 vs. $13,291, P=0.024), but significantly higher procurement costs ($22,991 vs. $25,589, P<0.0001). The increased procurement costs are likely due to proportionately more combined liver kidney (L-K) transplants in the POST era, but this increase was not significant (4/41 vs. 5/34, P=0.723). When the HCC recipients are excluded from these analyses, we still observe no differences in 1-year total direct costs (P=0.51), LOS (P=0.81), and still find significant reductions in blood bank (P=0.045), and pharmacy (P=0.032) costs and increased procurement costs (P=0.002) for the POST period. Overall one-year patient (85% PRE vs. 87% POST, P=0.87) and graft (0.85 PRE vs. 0.80 POST, P=0.64) survival are not different for the two groups. Conclusions: We conclude that under the new MELD allocation system, despite significantly higher MELD scores at transplant, direct costs and resource utilization have not increased. Improvements in operative management, and development of better, more economical pharmaceuticals are responsible for reduced liver transplant costs, even when sicker patients are receiving transplants." @default.
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• W2024129191 date "2004-07-01" @default.
• W2024129191 modified "2023-09-27" @default.
• W2024129191 title "DIRECT COSTS FOR ONE YEAR OF LIVER TRANSPLANT CARE ARE NOT INCREASED IN THE MELD ERA" @default.
• W2024129191 doi "https://doi.org/10.1097/00007890-200407271-01059" @default.
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