Journal article
The effects of Share 35 on the cost of liver transplantation
Clinical transplantation, Vol.31(5), pp.e12937-n/a
05/2017
DOI: 10.1111/ctr.12937
PMID: 28235131
Abstract
On June 18, 2013, the United Network for Organ Sharing (UNOS) instituted a change in the liver transplant allocation policy known as "Share 35." The goal was to decrease waitlist mortality by increasing regional sharing of livers for patients with a model for end-stage liver disease (MELD) score of 35 or above. Several studies have shown Share 35 successful in reducing waitlist mortality, particularly in patients with high MELD. However, the MELD score at transplant has increased, resulting in sicker patients, more complications, and longer hospital stays. Our study aimed to explore factors, along with Share 35, that may affect the cost of liver transplantation. Our results show Share 35 has come with significantly increased cost to transplant centers across the nation, particularly in regions 2, 5, 10, and 11. Region 5 was the only region with a median MELD above 35 at transplant, and cost was significantly higher than other regions. Several other recipient factors had changes with Share 35 that may significantly affect the cost of liver transplant. While access to transplantation for the sickest patients has improved, it has come at a cost and regional disparities remain. Financial implications with proposed allocation system changes must be considered.
Details
- Title: Subtitle
- The effects of Share 35 on the cost of liver transplantation
- Creators
- Jennifer Berumen - University of California, San DiegoMichael Misel - University of California, San DiegoIrine Vodkin - University of California, San DiegoJeffrey B Halldorson - University of California, San DiegoKristin L Mekeel - University of California, San DiegoAlan Hemming - University of California, San Diego
- Resource Type
- Journal article
- Publication Details
- Clinical transplantation, Vol.31(5), pp.e12937-n/a
- DOI
- 10.1111/ctr.12937
- PMID
- 28235131
- ISSN
- 0902-0063
- eISSN
- 1399-0012
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Surgery
- Record Identifier
- 9984321861802771
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