ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Functional Status and Comorbidity Are Associated with High Costs After Liver Transplantation.

M. Serper, M. Rossi, T. Bitterman, A. Shaked, K. Olthoff.

University of Pennsylvania, Philadelphia.

Meeting: 2016 American Transplant Congress

Abstract number: 452

Keywords: Economics, Liver transplantation, Outcome

Session Information

Date: Tuesday, June 14, 2016

Session Name: Concurrent Session: Living Donation and Transplant: Operational and Economic Factors

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:30pm-3:42pm

Location: Room 311

Related Abstracts
  • Muscle Mass Measurement Is Objective and More Predictive of Expected Mortality Than Functional Status in High MELD Liver Transplant Recipients
  • Functional Status Predicts Mortality After Liver Transplant

Purpose: The purpose of this study was to identify the clinical characteristics associated with high costs of liver transplantation (LT) at a large transplant center with a specific focus on functional status.

Methods: A retrospective cohort study was conducted at a single center from 2008-2013. Clinical data were abstracted from the transplant data warehouse; utilization costs (direct and indirect) of the LT episode were obtained from the Lawson General Ledger System. Functional status was assessed with Karnofsky performance status. Multivariate logistic regression evaluated factors associated with the highest cost quartile.

Results: A total of 728 patients underwent LT; 6.5% (n=47) had multi-organ transplant. The median LT cost was $139,880 (IQR: $121,986-$183,921); 10% (n=75) had a cost of ≥$250,000. The mean age of the study sample was 56 (SD=10), 70% were male and 42% had hepatitis C. Median MELD at LT was 20 (IQR: 13-30) and median length of stay was 10 days (IQR: 7-19). A total of 30% (n=206) of patients had severely disabled functional status and n=20 (3%) were moribund; a total of 8% (n=55) were discharged to a skilled nursing or long term acute care facility after LT. Median transplant costs increased incrementally with worsening functional status: (independent function: $124,903; needs assistance: $141,068; very disabled: $157,274; moribund: $181,115). A total of 38% of severely disabled/moribund patients incurred LT costs in the highest quartile compared to 19% of patients with independent functional status or those needing some assistance (p<0.001). In multivariate analysis adjusted for demographics, MELD score, pre-transplant ventilation and hemodialysis as well as discharge status: very disabled/moribund functional status (OR 1.7, 95% CI 1.1-2.6, p=0.014), hemodialysis (OR 3.7, 95% CI 1.8-7.3, p<0.001), mechanical ventilation (OR 2.5, 95% CI 1.5-4.2, p<0.001), and discharge to a skilled nursing/long term acute care facility (OR 2.5, 95% CI 1.3-5.2, p=0.010) were independently associated with LT cost in the highest quartile. Factors associated with lower costs were younger age (OR 0.98 for each year decrease, 95% CI 0.96-0.99, p=0.042) and lower recipient BMI (OR 0.95 for each point decrease, 95% CI 0.92-0.99, p=0.015). No association was noted between MELD score and cost.

Conclusion: Functional status is an important determinant of LT associated costs. Future studies should prospectively evaluate the impact of functional status on long-term LT costs.

CITATION INFORMATION: Serper M, Rossi M, Bitterman T, Shaked A, Olthoff K. Functional Status and Comorbidity Are Associated with High Costs After Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Serper M, Rossi M, Bitterman T, Shaked A, Olthoff K. Functional Status and Comorbidity Are Associated with High Costs After Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/functional-status-and-comorbidity-are-associated-with-high-costs-after-liver-transplantation/. Accessed March 9, 2021.

« Back to 2016 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Live Related Kidney Transplant Experience in Abuja, Nigeria – First Eight Cases Ever.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.