Liver Transplantation Costs for End‐Stage Liver Disease

Review Article

Liver Transplantation Costs for End‐Stage Liver Disease

R Paolo Salvalaggio, Alex Cantafio and Martin I Montenovo

Department of Surgery, University of Washington, Seattle, WA


ABSTRACT

Liver transplantation is the treatment of choice for patients with end‐stage liver disease. The estimated annual cost of liver transplantation in the United States exceeds 1 billion dollars. The costs of liver transplantation are impacted by the severity of liver disease, comorbidities of the recipient, donor and transplant center factors. The implementation of the MELD score in organ allocation and the utilization of donors of low quality have contributed to a recent increase in resource consumption after liver transplantation. Present utilization of transplant registries without cost information makes difficult the study of the costs of liver transplantation. To permit clear understanding of the costs in liver transplantation and advance the field with concomitant cost reduction, the transplant community must investigate the impact of outliers in the cost of liver transplantation, design better clinical tools to better match donors and recipients, understand how resources are consumed by patients with high MELD scores, and focus in better contracting.

Keywords: liver transplantation, cost, reimbursement, model for end‐stage liver disease (MELD), donor risk index (DRG)

Correspondence: Paolo R Salvalaggio, Division of Transplant Surgery, Department of Surgery, University of Washington, UWMC Box 356410, 1959 NE Pacific St EE 412, Seattle, WA 98195, USA. Tel: (1)‐206‐598‐6263; Fax: (1)‐206‐598‐7449; e‐mail: psalvala@u.washington.edu

Affiliation: