Background. After implementation of the “Share 35” policy in 2013, many centers and OPOs reported increased costs associated with broader sharing. The OPTN Liver and Intestinal Transplantation Committee sought to quantify these costs as it explores various concepts to further broaden sharing. Methods. Forty liver programs were asked to provide organ charges (e.g., acquisition, surgeon fees), transport mode (e.g., flight, ground) and transport charges for up to 50 of their liver transplants performed in 2014. Other requested data included post-operative variables related to recipient costs (lab MELD at transplant) and times associated with recovery and transplantation. Results. Responses were received from 28 centers (70% of sample) for 1039 transplants (17% of all deceased donor whole liver transplants in 2014), from 9 of 11 Regions. Of these organs 65% were transported by air, with median charges for local vs regional or national air transport of $3892, $9796, and $13099. Median organ procurement charges increased from $38,350 for local to $56,967/$56,894 for regional/national. Transport and total organ charges were strongly correlated with distance (r=0.79 and 0.64, p<0.001) . Median recipient charges for Lab MELD scores < 24 were $248,140 vs $449,996 for lab MELD 35+. Overall recipient charges were strongly correlated with LOS (r=0.61, p<0.001) and only weakly with MELD score (r=0.24, p<0.001). Discussion: This is the first survey to capture actual data on the costs of broader sharing for a large sample of liver transplants. While not representing all regions or programs, these data nevertheless provide insights into the potential financial impacts associated with sharing organs across greater distances.

CITATION INFORMATION: Harper A, Edwards E, Gilroy R, Chapman W, Mulligan D, Klintmalm G. The Finances of Broader Sharing of Livers Following Share 35. Am J Transplant. 2016;16 (suppl 3).

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