Descriptive Analysis of Patients Who Travel Away from Home for Orthotopic Liver Transplantation
1Department of Organ Transplant, Scripps Clinic/Green Hospital, La Jolla, CA
2Department of Molecular & Experimental Medicine, The Scripps Research Institute, La Jolla, CA
3United Network for Organ Sharing, United Network for Organ Sharing, Richmond, VA.
Meeting: 2015 American Transplant Congress
Abstract number: C111
Keywords: Allocation, Liver transplantation, Resource utilization, Waiting lists
Session Information
Session Name: Poster Session C: Liver Donation and Allocation
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Aim: Given the current geographic disparities in access to liver transplantation (OLT), there is a segment of the population that may travel to different areas of the country to access OLT at a lower MELD. The purpose of this study was to evaluate the rate of travel and demographic or survival differences.
Methods: The OPTN database was queried for all patients who underwent a deceased donor liver transplant from 2010-2013. 182 patients were excluded because state of residence was unknown. Demographic, insurance, transplant, and survival data were analyzed for the remaining 25,159 patients. Patients who traveled for OLT(TRV) were compared to patients who underwent OLT within their home state or region(NTRV).
Results: From 2010-2013, 5525 patients traveled outside of their home state for OLT(21.8% of all transplants). 2998 patients(11.8%) traveled outside of their home region for OLT. 58.8% of TRV were done in 4 regions (2,3,8, and 11). The mean distance traveled was 408 miles for TRV, compared to 55.7 miles for NTRV. Recipient age was similar (TRV 49.5 yrs vs NTRV 51.0 yrs). Median lab MELD at OLT was slightly lower for TRV(21.1 vs 22.1). More TRV OLT were done with a Match MELD 15-34(73.3% vs 71.16%) and less with MELD 35+(16.3% vs 19.6%)(p<0.001). The TRV group contained proportionally more men than the NTRV group(67.3% vs 64.3%)(p<0.001). The TRV group also contained more Caucasians than the NTRV group(74.8% vs 67.3%)(p<0.001). Insurance was also different in the two groups, with the TRV group containing 60.8% private insurance, 21% Medicare & Choice, 9.2% Medicaid, and 6.17% Department of VA, compared to the NTRV group, which had 53.8% private insurance, 24.7% Medicare & Choice, 18.1% Medicaid, and 0.93% Department of VA(p<0.001). The number of MELD exceptions was similar in the two groups(34.4% TRV vs 34.8% NTRV). Overall survival was similar between TRV and NTRV.
Conclusions: A significant proportion of patients travel away from home for OLT. These patients tend to be younger, Caucasian, and male, have a slightly lower MELD and are more likely to have private insurance compared to the patients who do not travel for a transplant.
To cite this abstract in AMA style:
Frenette C, Harper A, Waalen J, Fisher J, Schaffer R, Baquerizo A, Marsh C. Descriptive Analysis of Patients Who Travel Away from Home for Orthotopic Liver Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/descriptive-analysis-of-patients-who-travel-away-from-home-for-orthotopic-liver-transplantation/. Accessed May 11, 2025.« Back to 2015 American Transplant Congress