INTRODUCTION: Normothermic machine perfusion (NMP) for liver transplantation is a novel and promising technique.One of the concerns related to its usage is the high cost.The aim of our study is to analyze the impact of NMP on costs of liver transplantation (LT).

METHODS: We conducted a retrospective analysis on a series of 15 LT patients receiving an NMP perfused graft at our institution.The device was developed at our Institution and used under an FDA regulated clinical trial.We included costs related to: blood products consumption and operating room (OR) time after reperfusion, ICU and regular ward (RW)stay. In order to make our finding generalizable,data on cost of NMP transplants are reported as a percentage of the cost in our transplant control patients.Standard costs average was calculated from 60 historic control patients matched for age,MELD score,Donor Risk Index.Costs related to NMP included: components and assembly (annualized on a hypothetical number of 40 LTs for 10 years),perfusate blood products and drugs, disposable materials.

RESULTS:LT performed using NMP cost 114,9% compared to our average control patients (100%).When the NMP technology costs were subtracted and only the cost of LT accounted for (OR time, blood products infused, length of stay), NMP transplants resulted in a 36% reduction in cost.This was due to lower blood products usage, OR costs, shorter ICU and RW stay in NMP group compared to controls.

CONCLUSION: This single center analysis shows that NMP LT are currently more expensive as compared to controls.This is likely due to the high cost of our disposable, and the safety technology (two pumps and two sets of disposables) that we incorporated in our device.We expect that as the cost of disposable decreases, NMP will be much more cost effective and potentially even cost saving due to shorter hospital stay, decreased incidence of complications and better patient recovery.

CITATION INFORMATION: Pezzati D., Liu Q., Hassan H., Iuppa G., Hernandez L., D'Amico G., Diago Uso T., Heghtsad B., Miller C., Quintini C. A Cost Analysis on Normothermic Machine Perfusion at a Single Center Am J Transplant. 2017;17 (suppl 3).

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