The goal of this proposal is to identify factors which determine the cost of liver transplantation. Our center has participated in the NIDDK Liver Transplant Database (LTD), a five year project which has prospectively collected detailed clinical data on 919 consecutive liver transplants performed at three major centers. By merging a resource utilization database with the LTD, important information regarding the determinants of the cost of liver transplantation will be obtained.
The specific aims of this project are: 1) To develop mathematical models which predict the cost of orthotopic liver transplantation (OLT) based on the recipient's pre-transplant clinical and demographic profile 2) To determine the impact of different organ allocation schemes on the cost of liver transplantation. Three strategies will be employed to analyze the data. Once the cost data has been merged with the clinical data, univariate and multi-variate analyses will be performed to identify clinical features which are associated with increased cost of OLT. Second, models will be constructed which can predict the cost of OLT based on a specific clinical profile. Finally, using these models, we will determine the economic impact of different schemes of organ allocation. These studies will provide important insights into this costly yet effective therapy for end-stage liver disease. By understanding the factors that influence costs we hope to be able to better evaluate new therapies, evaluate and modify our current system of organ allocation, and make liver transplantation more cost effective.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
1F32HS000098-01
Application #
2235640
Study Section
VA Health Services Research and Development Scientific Merit Review Board (HSRD)
Program Officer
Rudzinski, Karen
Project Start
1995-12-01
Project End
Budget Start
1995-06-28
Budget End
1996-06-30
Support Year
1
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Brown Jr, R S; Lombardero, M; Lake, J R (1996) Outcome of patients with renal insufficiency undergoing liver or liver-kidney transplantation. Transplantation 62:1788-93