Abstract:
BACKGROUND:Hepatic transplantation is a highly effective but costly treatment for end-stage hepatic dysfunction. One approach to improve efficiency in the use of scarce organs for transplantation is to identify preoperative factors that are associated with poor outcome posttransplantation. This may assist both in selecting patients optimal for transplantation and in identifying strategies to improve survival. METHODS:In the present work, we retrospectively reviewed consecutive liver transplants performed at the University of California at Los Angeles during a 6-year period and determined preoperative variables that were associated with outcome in primary grafts. In addition, we used the hospital's cost accounting database to determine the impact of these variables on the degree of resource use by high-risk patients. RESULTS:We found five variables to have independent prognostic value in predicting graft survival after primary liver transplantation: (1) donor age, (2) recipient age, (3) donor sodium, (4) recipient creatinine, and (5) recipient ventilator requirement pretransplant. Recipient ventilator requirement and elevated creatinine were associated with significant increases in resource use during the transplant admission. CONCLUSIONS:Patients at high risk for graft failure and costly transplants can be identified preoperatively by a set of parameters that are readily available, noninvasive, and inexpensive. Selection of recipients on the basis of these data would improve the efficiency of liver transplantation and reduce its cost.
journal_name
Transplantationjournal_title
Transplantationauthors
Markmann JF,Markmann JW,Markmann DA,Bacquerizo A,Singer J,Holt CD,Gornbein J,Yersiz H,Morrissey M,Lerner SM,McDiarmid SV,Busuttil RWdoi
10.1097/00007890-200109270-00023subject
Has Abstractpub_date
2001-09-27 00:00:00pages
1113-22issue
6eissn
0041-1337issn
1534-6080journal_volume
72pub_type
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