Effects of broader geographic distribution of donor lungs on travel mode and estimated costs of organ procurement
Effects of broader geographic distribution of donor lungs on travel mode and estimated costs of organ procurement
复制标题
供肺更广泛的地理分布对出行方式和器官采购估计成本的影响
DOI：
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发表时间：
2021
影响因子：
8.8
通讯作者：
M. Valapour
中科院分区：
文献类型：
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作者：
C. Lehr;M. Skeans;E. Lease;M. Valapour
2017年11月24日，美国肺移植政策将250海里半径的供体服务区取代为第一个分配单位。了解这项政策的经济影响是重要的，因为美国准备采取最广泛的可行的地理器官分布。所有肺移植受者从2015年1月1日至2018年12月31日，在移植受者的科学登记，包括在内。2017年11月24日之前和之后的接收者分别处于供体服务区-第一和250海里供体服务区-自由期。使用Google应用程序估计旅行时间;当驾驶时间超过60分钟时，将模式分配为飞行。在政策变化下，器官采购的旅行距离和时间增加了。器官空运的估计比例从61%增加到76%。如果旅行方式改为飞行，估计平均费用增加14 051美元，导致所有移植平均增加1264美元。<18岁的候选人和肺分配分数高的成年人的旅行费用最高。更广泛的地理分布增加了一小部分肺移植的估计器官采购成本。进一步的分析应阐明这些政策的广泛经济影响。
On November 24, 2017, US lung transplant policy replaced donor service area with 250‐nautical‐mile radius as the first unit of allocation. Understanding this policy's economic impact is important, because the United States is poised to adopt the broadest feasible geographic organ distribution. All lung transplant recipients from January 1, 2015, to December 31, 2018, in the Scientific Registry of Transplant Recipients, were included. Recipients before and after November 24, 2017 were in the donor service area‐first and 250‐nautical‐mile donor service area‐free periods, respectively. Travel time was estimated using a Google application; mode was assigned as flying when driving time was longer than 60 min. Travel costs were estimated by mode and distance. Travel distance and time for organ procurement increased under the policy change. The estimated proportion of organs traveling by air increased from 61% to 76%. Estimated average costs increased by $14 051 if travel mode changed to flying, resulting in an average increase of $1264 for all transplants. Travel costs were highest for candidates <18 years and adults with high lung allocation scores. Broader geographic distribution increased estimated organ procurement costs for a small percentage of lung transplants. Further analysis should elucidate the broad economic impact of such policies.