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73


Long-Term Impact of Live Liver Donation: A Self Report of the Donation Experience

Rudow, Dianne LaPointe; DeLair, Samantha; Feeley, Thomas; Florman, Sander; Guarrera, James; Kinkhabwala, Milan; Orloff, Mark; Teperman, Lewis; Morgan, Glyn
Outcomes for adult-to-adult living liver donors are largely based on short-term data drawn from single center studies. The aim of this study was to determine how living liver donation impacts self-reported Quality-of-Life up to 6 years post-donation in a sample of NYS residents.
PMID: 30589993
ISSN: 1527-6473
CID: 3560442

A Sustained Viral Response Achieved with Sofosbuvir/Ledipasvir May Increase the Incidence of Acute Cellular Rejection Post Liver Transplantation [Meeting Abstract]

Bortecen, K; Layman, R; Gelb, B; Winnick, A; Morgan, G; Tobias, H; Teperman, L
ISI:000383373902143
ISSN: 1600-6143
CID: 2386272

What Are the Charges and Costs of Transplanting High MELD Patients? [Meeting Abstract]

Bortecen, K; Gelb, B; Winnick, A; Morgan, G; Teperman, L
ISI:000383373902448
ISSN: 1600-6143
CID: 2386282

What are the true costs of transplanting high MELD patients? [Meeting Abstract]

Bortecen, K; Freitas, D; Bekisz, J; Gelb, B; Winnick, A; Morgan, G; Teperman, L
Purpose: There is a significant variation in the MELD scores and subsequent morbidity among liver recipients in the US. Larger OPOs consistently serve patients with advanced disease. Previous studies have shown 2.5 times greater prevalence of transplanted patients with MELD 3 24 in these OPOs. CMS recent reimbursement adjustments may disproportionately affect certain programs given their increased prevalence of patients with more advanced disease. Methods: We analyzed the prevalence of transplants among patients with high UNET MELD scores and associated charges, costs, and reimbursements. We compared low, medium and high MELD score groups. Between 2014-2015, 43 liver transplants, all with >30 days survival, were analyzed. Results: Only 2 had MELD scores below 25 at transplant, both of which from live donors. 95% of patients had MELD scores above 25 and among these, 18% had MELD 40 or were Status 1. Compared to the national average, our MELD scores were: 25% 21-30 (National 21.5%, p >0.05), 70.5% 31-40 (National 25.9%, p < 0.001), and 4.5% Status 1 (National 5.9%, p >0.05). For MELD scores 21-30, hospital charges averaged $645,214 and reimbursements were $150,706. For MELD scores 31-39, charges were $686,720, and reimbursement were $139,776. Reviewing MELD 40/ Status 1 patients, the average hospital charges and reimbursements were $1,136,813 and $293,776 respectively. We compared their amounts to the MELD 40 patients who had hospital charges of $625,371 and reimbursements of $142,051 respectively. This demonstrated a loss of $843,037 for the first group and $483,320 for the second. Length of stay was 32 days for MELD 40/ Status 1 and 8 days for MELD 40 (p < 0.000). Conclusion: 3 40 MELD patients have a huge financial impact on institutions. The difference between 25-39 and 340 MELD points is greater than half a million dollars. These data reflect and include dialysis, intubation and ICU stay but do not include rehabilitation expenses which will be the focus of another study. We find that our institution, which likely reflects many institutions in our OPO, serves sicker patients and therefore incurs higher costs but receives lower reimbursements, as they are based on national expected care costs for healthier patients. A broader sharing in the US may equalize costs. Payers should take into account the added financial burden of performing transplant in high MELD patients
EMBASE:614325724
ISSN: 0041-1337
CID: 2454462

An Excellent Sustained Viral Response Is Achieved in Post Liver Transplant HCV Recipients Using Sofosbuvir/Ribavirin [Meeting Abstract]

Hamshow, M; Bortecen, K; Winnick, A; Gelb, B; Morgan, G; Teperman, L
ISI:000368626500417
ISSN: 1534-6080
CID: 1989332

A Simple PTC Taste Test Is a Cost-Effective Adjunct To the Current Selection Criteria for Liver Transplantation [Meeting Abstract]

Bortecen, K; Hamshow, M; Gelb, B; Winnick, A; Morgan, G; Teperman, L
ISI:000368626500521
ISSN: 1534-6080
CID: 1989562

Interferon-Free Sofosvir/Ribavirin Treatment Achieves Excellent Sustained Viral Response in Post Liver Transplant HCV Recipients [Meeting Abstract]

Hamshow, M; Bortecen, K; Layman, R; Winnick, A; Gelb, B; Morgan, G; Teperman, L
ISI:000370124201050
ISSN: 1600-6143
CID: 2049032

CO2 Angiography Provides a Safe Alternative to Iodinated Contrast Agents in the Diagnosis and Endovascular Treatment of Transplant Renal Artery Stenosis [Meeting Abstract]

Gelb, B; Cayne, N; Benstein, J; Morgan, G; Bortecen, K; Hamshow, M; Teperman, L
ISI:000370124201389
ISSN: 1600-6143
CID: 2049062

Cost-Effective, Simple PTC Tasting Could Be a Useful Adjunct to Selection Criteria of ARLD Patients [Meeting Abstract]

Bortecen, K; Freitas, D; Teperman, C; Hamshow, M; Gelb, B; Morgan, G; Teperman, L
ISI:000370124201602
ISSN: 1600-6143
CID: 2049222

Utilization of Simultaneous Liver-Kidney Transplants Continues to Vary Dramatically by UNOS Region [Meeting Abstract]

Gaglio, Paul J.; Rabbenou, Wendy; Florman, Sander S.; Kato, Tomoaki; Kinkhabwala, Milan; Morgan, Glyn; Orloff, Mark S.; Teperman, Lewis; DeLair, Samantha
ISI:000344483801275
ISSN: 0270-9139
CID: 4519422