LIVER-TRANSPLANTATION IN OHIO

Background. Since its inception in 1984, the Ohio Solid Organ Transpla ntation Consortium has tracked liver transplantation outcomes for its five member institutions Presented herein is a 12-year summary of this data analyzed to determine whether, with increasing experience, outco mes have improved in a cost-effective manner. Methods. Between July 19 84 and June 1996, 1,063 liver transplants were performed In Ohio in 94 3 patients (772 adults and 171 children), of which 943 were primary an d 120 were retransplants (13%). Outcome comparisons were made for thre e eras: 1984-1988, 1988-1992, and 1992-1996. Results. The percentage o f urgent (United Network for Organ Sharing status 1 and 2) transplants has decreased (62% to 41%), whereas that of homebound patients has in creased (38% to 59%). Average time on the waiting list has increased f rom 39 to 165 days, and the average length of stay has decreased from 44 to 27 days. Patient survival at 1-year increased in each era (64%, 80%, and 82%, respectively). Although actual hospital charges have rem ained relatively constant, they have decreased substantially when comp ared in 1985 dollars as corrected for inflation. Conclusions. Patients undergoing liver transplantation in Ohio are now listed earlier in th e course of their disease and wait longer for their transplant, but en joy a better chance of survival, have a shorter hospital stay, and a r elatively less expensive operation. These data indicate that with incr eased experience, the Ohio Solid Organ Transplantation Consortium live r transplantation teams perform liver transplantation in a more cost-e ffective manner.