Examine the relationship between transplant-related total cost and 1-year graft failure and patient mortality rate for liver transplantation at freestanding children's hospitals.

Using the Pediatric Health Information Systems database, a retrospective study of 471 patients that underwent liver transplantation at 15 freestanding children's hospitals from Jan 2010-Dec 2012 was performed. 1y graft failure and patient mortality rates from July 2010-Dec 2012 for each center were obtained from the Scientific Registry of Transplant Recipients. Aggregate and hospital-specific 30d readmission rate, length of stay (LOS), ICU LOS, total hospital costs, 1y graft failure rate and 1y patient mortality were analyzed. Statistical outliers were identified. Spearman's correlation (ρ) was performed between each variable.

Significant variation was found in total cost, LOS, ICU, 30d readmission rate and 1y patient mortality rate between centers, however, there was no significant difference in 1-year graft failure rates.

There is no correlation between cost of pediatric liver transplantation and 1y graft failure and 1y patient mortality rates. These data suggest that identifying practice patterns at low-cost centers and implementing them at higher-cost centers may decrease the cost of pediatric liver transplantation without compromising outcomes.

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