TY - JOUR
T1 - Economic evaluation of the specialized donor care facility for thoracic organ donor management
AU - Gauthier, Jason M.
AU - Majella Doyle, Maria B.
AU - Chapman, William C.
AU - Marklin, Gary
AU - Witt, Chad A.
AU - Trulock, Elbert P.
AU - Byers, Derek E.
AU - Hachem, Ramsey R.
AU - Pasque, Michael K.
AU - Meyers, Bryan F.
AU - Alexander Patterson, G.
AU - Nava, Ruben G.
AU - Kozower, Benjamin D.
AU - Kreisel, Daniel
AU - Chang, Su Hsin
AU - Puri, Varun
N1 - Funding Information:
uniform disclosure form (available at http://dx.doi. org/10.21037/jtd-20-1575). JMG reports grants from NIH, during the conduct of the study. MBBD reports personal fees from Novartis, outside the submitted work. WCC reports personal fees from Novartis, Pathfinder, and Mid-American Transplant, outside of the submitted work. DK serves as an unpaid editorial board member of Journal of Thoracic Disease from Mar 2019 to Feb 2021, reports grants and personal fees from Compass Therapeutics, outside the submitted work, and has a patent pending entitled “Compositions and methods for detecting CCR2 receptors” (application number 15/611,577). SHC and VP report grants from NIH and Mid-America Transplant Foundation, during the conduct of the study. The other authors have no conflicts of interest to declare.
Funding Information:
Funding: This work was supported by NIH grants F32 HL-143950 (JMG), R01 HL146856-01A1 (VP), and R21 DK-110530 (SHC) and Mid-America Transplant Foundation grant 022017 (VP, SHC). The funding organizations did not directly contribute to the identification, design, conduct, or reporting of the analysis.
Publisher Copyright:
© 2020 AME Publishing Company. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Background: Over the last decade two alternative models of donor care have emerged in the United States: the conventional model, whereby donors are managed at the hospital where brain death occurs, and the specialized donor care facility (SDCF), in which brain dead donors are transferred to a SDCF for medical optimization and organ procurement. Despite increasing use of the SDCF model, its cost-effectiveness in comparison to the conventional model remains unknown. Methods: We performed an economic evaluation of the SDCF and conventional model of donor care from the perspective of U.S. transplant centers over a 2-year study period. In this analysis, we utilized nationwide data from the Scientific Registry of Transplant Recipients and controlled for donor characteristics and patterns of organ sharing across the nation's organ procurement organizations (OPOs). Subgroup analysis was performed to determine the impact of the SDCF model on thoracic organ transplants. Results: A total of 38,944 organ transplants were performed in the U.S. during the study period from 13,539 donors with an observed total organ cost of $1.36 billion. If every OPO assumed the cost and effectiveness of the SDCF model, a predicted 39,155 organ transplants (+211) would have been performed with a predicted total organ cost of $1.26 billion (−$100 million). Subgroup analysis of thoracic organs revealed that the SDCF model would lead to a predicted 156 additional transplants with a cost saving of $24.6 million. Conclusions: The U.S. SDCF model may be a less costly and more effective means of multi-organ donor management, particularly for thoracic organ donors, compared to the conventional hospital-based model.
AB - Background: Over the last decade two alternative models of donor care have emerged in the United States: the conventional model, whereby donors are managed at the hospital where brain death occurs, and the specialized donor care facility (SDCF), in which brain dead donors are transferred to a SDCF for medical optimization and organ procurement. Despite increasing use of the SDCF model, its cost-effectiveness in comparison to the conventional model remains unknown. Methods: We performed an economic evaluation of the SDCF and conventional model of donor care from the perspective of U.S. transplant centers over a 2-year study period. In this analysis, we utilized nationwide data from the Scientific Registry of Transplant Recipients and controlled for donor characteristics and patterns of organ sharing across the nation's organ procurement organizations (OPOs). Subgroup analysis was performed to determine the impact of the SDCF model on thoracic organ transplants. Results: A total of 38,944 organ transplants were performed in the U.S. during the study period from 13,539 donors with an observed total organ cost of $1.36 billion. If every OPO assumed the cost and effectiveness of the SDCF model, a predicted 39,155 organ transplants (+211) would have been performed with a predicted total organ cost of $1.26 billion (−$100 million). Subgroup analysis of thoracic organs revealed that the SDCF model would lead to a predicted 156 additional transplants with a cost saving of $24.6 million. Conclusions: The U.S. SDCF model may be a less costly and more effective means of multi-organ donor management, particularly for thoracic organ donors, compared to the conventional hospital-based model.
KW - Heart
KW - Lung
KW - Organ donor management
KW - Transplantation
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=85096086408&partnerID=8YFLogxK
U2 - 10.21037/jtd-20-1575
DO - 10.21037/jtd-20-1575
M3 - Article
C2 - 33209403
AN - SCOPUS:85096086408
SN - 2072-1439
VL - 12
SP - 5709
EP - 5717
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 10
ER -