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Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality?

Publication ,  Journal Article
Montgomery, JR; Highet, A; Hobeika, MJ; Englesbe, MJ; McElroy, LM
Published in: Clin Transplant
February 2020

Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers.

Duke Scholars

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

February 2020

Volume

34

Issue

2

Start / End Page

e13780

Location

Denmark

Related Subject Headings

  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Michigan
  • Liver Transplantation
  • Liver
  • Humans
  • Graft Survival
  • Death
  • Brain Death
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Montgomery, J. R., Highet, A., Hobeika, M. J., Englesbe, M. J., & McElroy, L. M. (2020). Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality? Clin Transplant, 34(2), e13780. https://doi.org/10.1111/ctr.13780
Montgomery, John R., Alexandra Highet, Mark J. Hobeika, Michael J. Englesbe, and Lisa M. McElroy. “Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality?Clin Transplant 34, no. 2 (February 2020): e13780. https://doi.org/10.1111/ctr.13780.
Montgomery JR, Highet A, Hobeika MJ, Englesbe MJ, McElroy LM. Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality? Clin Transplant. 2020 Feb;34(2):e13780.
Montgomery, John R., et al. “Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality?Clin Transplant, vol. 34, no. 2, Feb. 2020, p. e13780. Pubmed, doi:10.1111/ctr.13780.
Montgomery JR, Highet A, Hobeika MJ, Englesbe MJ, McElroy LM. Going the distance for procurement of donation after circulatory death livers for transplantation-Does reimbursement reflect reality? Clin Transplant. 2020 Feb;34(2):e13780.
Journal cover image

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

February 2020

Volume

34

Issue

2

Start / End Page

e13780

Location

Denmark

Related Subject Headings

  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Michigan
  • Liver Transplantation
  • Liver
  • Humans
  • Graft Survival
  • Death
  • Brain Death