Taking Liver Transplant to “The Friendly Skies”: A Novel Pilot Program Using Commercial Flights and Ride-Sharing Apps to Minimize Dry-Run Expenses and Expand Potential Donors
Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX
Meeting: 2020 American Transplant Congress
Abstract number: A-125
Keywords: Donors, marginal, Liver transplantation
Session Information
Session Name: Poster Session A: Liver: MELD, Allocation and Donor Issues (DCD/ECD)
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Growth in liver transplantation means using marginal/DCD donors, however these often fail to yield a suitable organ. Organ procurement can require travelling significant distances, but in some regions, all procurement transportation costs are borne by the transplant center, and the $15,000-$25,000 transportation costs for “dry-run” procurements aren’t reimbursable, discouraging some centers from pursuing remote marginal donors. We present a novel program using commercial airlines and ridesharing apps to limit dry-run expenses to aggressively pursue marginal donors
*Methods: Flyout via same day booked commercial flights. Ridesharing apps between airport and hospital for ground transport. If procurement successful, return via chartered jet (unless commercial flight viable option). Unsuccessful procurement return via commercial flight. We present our initial experience, cost savings, and patient outcomes
*Results: n=23 liver procurements (15 dry run, 8 successful) Capture rate 34.8%. DCD=19 ECD=4 Travel Details: 7 donor airports, 2 states (TX, OK), 3 different airline.
For the 15 dry-runs, total overall transportation cost was $19,196 vs an expected OPO charge of $246,385, saving $227,188. For the 8 successful procurements, 3 donors flew commercial both ways, (mean savings $19,638 per case and mean CIT 5:57), with the other 5 donors using chartered jets to return (mean saving $312 per case and mean CIT 5:32). Mean total ground transport cost was $373 per case. Mean hospital LOS for 8 liver transplant was 7.3d (range 3-17)
*Conclusions: This program enabled a cost-effective, aggressive pursuit of marginal/DCD livers from distant locations, and 8 additional unutilized livers were procured and transplanted with excellent outcomes. The outlay of $19,196 for transportation costs for dry-run procurements saved over $227,188 in expected transportation costs to gain these extra 8 liver. Additionally this showed the possibility of successfully transplanting livers using only commercial transport in optimal circumstances. Future options include expansions to other nearby states
To cite this abstract in AMA style:
McKenna GJ, Onaca N, Fernandez H, Martinez E, Gupta A, Wall A, Bayer J, Ruiz R, Testa G. Taking Liver Transplant to “The Friendly Skies”: A Novel Pilot Program Using Commercial Flights and Ride-Sharing Apps to Minimize Dry-Run Expenses and Expand Potential Donors [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/taking-liver-transplant-to-the-friendly-skies-a-novel-pilot-program-using-commercial-flights-and-ride-sharing-apps-to-minimize-dry-run-expenses-and-expand-potential-donors/. Accessed November 21, 2024.« Back to 2020 American Transplant Congress