Journal article
Biliary Complications After Liver Transplantation in the United States: Changing Trends and Economic Implications
Transplantation, Vol.107(5), pp.e127-e138
05/2023
DOI: 10.1097/TP.0000000000004528
PMID: 36928182
Abstract
Biliary complications (BCs) continue to impact patient and graft survival after liver transplant (LT), despite improvements in organ preservation, surgical technique, and posttransplant care. Real-world evidence provides a national estimate of the incidence of BC after LT, implications for patient and graft outcomes, and attributable cost not available in transplant registry data.
An administrative health claims-based BC identification algorithm was validated using electronic health records (N = 128) and then applied to nationally linked Medicare and transplant registry claims.
The real-world evidence algorithm identified 97% of BCs in the electronic health record review. Nationally, the incidence of BCs within 1 y of LT appears to have improved from 22.2% in 2002 to 20.8% in 2018. Factors associated with BCs include donor type (living versus deceased), recipient age, diagnosis, prior transplant, donor age, and donor cause of death. BCs increased the risk-adjusted hazard ratio (aHR) for posttransplant death (aHR, 1.43; P < 0.0001) and graft loss (aHR, 1.48; P < 0.0001). Nationally, BCs requiring intervention increased risk-adjusted first-year Medicare spending by $39 710 (P < 0.0001).
BCs remain an important cause of morbidity and expense after LT and would benefit from a systematic quality-improvement program.
Details
- Title: Subtitle
- Biliary Complications After Liver Transplantation in the United States: Changing Trends and Economic Implications
- Creators
- Priyadarshini Manay - University of IowaAbhinav Seth - Organ Transplant Center, University of Iowa Hospitals and Clinics, Iowa City, IAKyle Jackson - Johns Hopkins UniversityKrista L Lentine - Saint Louis UniversityMark A Schnitzler - Saint Louis UniversityHuiling Xiao - Saint Louis UniversityDorry L Segev - Johns Hopkins UniversityDavid A Axelrod - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.107(5), pp.e127-e138
- DOI
- 10.1097/TP.0000000000004528
- PMID
- 36928182
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Language
- English
- Electronic publication date
- 03/17/2023
- Date published
- 05/2023
- Academic Unit
- Surgery
- Record Identifier
- 9984378332202771
Metrics
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