Investigation of the factors affecting the cost and length of stay in liver tranplant patients

Liver transplantation is the only treatment modality that affects the survival rates in end stage liver diseases. However improvements on this alternative treatment depend on both an experienced crew and enough financial sources. In studies, the association of liver transplantation candidate factors such as; age, gender, aetiology, MELD score,CHILD score, UNOS score, the presence of DM or portal vein thrombosis (PVT) before transplantation, previous surgery history as well as the graft factors such as; donor age, donor gender, the cold ischemia time, living or cadaveric donation, presence of other diseases in donor, with cost are investigated. In this study we investigated the association of these factors with cost of liver transplantation.Totally 279 patients were included in this study.The data of patients were retrospectively obtained from the hospital recordings.The cost for patients included costs of the period from hospitalisation for transplantation till discharge.Thecost of one liver transplantation in our centre was found to be approximately 30.823 dollar in average. In investigation of the change of mean costs according to years,in year 2008 the mean cost was found to be significantly higher than all other years and till this year the costs were established to be progressively increased and after this year started to decrease.In evaluation of association of cost with candidate MELD scores; the costs of candidates with MELD score higher than 15 are found to be statistically significantly higher than that of the candidates with MELD core lower than 15 (p=0.02). While there was no significant difference in regards to cost between UNOS groups, in between CHILD groups, the mean cost of the patients in CHILD B group was significantly lower than that of patients in CHILD C group (p= 0.01).In examination of relationship of aetiology with cost, although there was no significant difference between aetiology groups, the highest cost was determined in HBV positive and HBV positive HCC (75% HBV positives) patients. There was no significant difference in regards to the cost between candidate age, gender and BMI groups.Presence of DM or PVT in candidate previous to transplantation or postoperatively antibiotic usage does not change the cost significantly. Preoperative candidate creatine values and cost showed a positive and significant correlation (p 0.01). Similar significant association have not been shown between donor age and costhowever transplantations from living donor have been shown to have significantly higher costs when compared with transplantations from cadaveric donors (p= 0.01).