Addition of adult-to-adult living donation to liver transplant programs improves survival but at an increased cost
dc.contributor.author | Northup, Patrick G. | en_US |
dc.contributor.author | Abecassis, MIchael M. | en_US |
dc.contributor.author | Englesbe, Michael J. | en_US |
dc.contributor.author | Emond, Jean C. | en_US |
dc.contributor.author | Lee, Vanessa D. | en_US |
dc.contributor.author | Stukenborg, George J. | en_US |
dc.contributor.author | Tong, Lan | en_US |
dc.contributor.author | Berg, Carl L. | en_US |
dc.date.accessioned | 2009-03-03T20:11:48Z | |
dc.date.available | 2010-04-14T17:40:06Z | en_US |
dc.date.issued | 2009-02 | en_US |
dc.identifier.citation | Northup, Patrick G.; Abecassis, Michael M.; Englesbe, Michael J.; Emond, Jean C.; Lee, Vanessa D.; Stukenborg, George J.; Tong, Lan; Berg, Carl L. (2009). "Addition of adult-to-adult living donation to liver transplant programs improves survival but at an increased cost." Liver Transplantation 15(2): 148-162. <http://hdl.handle.net/2027.42/61905> | en_US |
dc.identifier.issn | 1527-6465 | en_US |
dc.identifier.issn | 1527-6473 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/61905 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=19177435&dopt=citation | en_US |
dc.description.abstract | Using outcomes data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we performed a cost-effectiveness analysis exploring the costs and benefits of living donor liver transplantation (LDLT). A multistage Markov decision analysis model was developed with treatment, including medical management only (strategy 1), waiting list with possible deceased donor liver transplantation (DDLT; strategy 2), and waiting list with possible LDLT or DDLT (strategy 3) over 10 years. Decompensated cirrhosis with medical management offered survival of 2.0 quality-adjusted life years (QALYs) while costing an average of $65,068, waiting list with possible DDLT offered 4.4-QALY survival and a mean cost of $151,613, and waiting list with possible DDLT or LDLT offered 4.9-QALY survival and a mean cost of $208,149. Strategy 2 had an incremental cost-effectiveness ratio (ICER) of $35,976 over strategy 1, whereas strategy 3 produced an ICER of $106,788 over strategy 2. On average, strategy 3 cost $47,693 more per QALY than strategy 1. Both DDLT and LDLT were cost-effective compared to medical management of cirrhosis over our 10-year study period. The addition of LDLT to a standard waiting list DDLT program is effective at improving recipient survival and preventing waiting list deaths but at a greater cost. Liver Transpl 15:148–162, 2009. © 2009 AASLD. | en_US |
dc.format.extent | 244669 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Surgery | en_US |
dc.title | Addition of adult-to-adult living donation to liver transplant programs improves survival but at an increased cost | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Surgery and Anesthesiology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Surgery, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Department of Surgery, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Virginia, Charlottesville, VA ; Telephone: 434-243-2718; FAX: 434-244-7529 ; Division of Gastroenterology and Hepatology, University of Virginia Health System, P.O. Box 800708, Jefferson Park Avenue and Lee Street, MSB 2142, Charlottesville, VA 22908-0708 | en_US |
dc.contributor.affiliationother | Department of Surgery, Northwestern University, Chicago, IL | en_US |
dc.contributor.affiliationother | Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Virginia, Charlottesville, VA | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Virginia, Charlottesville, VA ; Department of Health Sciences, University of Virginia, Charlottesville, VA | en_US |
dc.contributor.affiliationother | Department of Medicine, University of Virginia, Charlottesville, VA | en_US |
dc.identifier.pmid | 19177435 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/61905/1/21671_ftp.pdf | |
dc.identifier.doi | 10.1002/lt.21671 | en_US |
dc.identifier.source | Liver Transplantation | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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