ORGAN ALLOCATION AND THE COST OF LIVER TRANSPLANTATION

这项建议的目标是确定决定成本的因素 肝移植的最新进展。我们中心参加了NIDDK肝脏 移植数据库(有限公司)，这是一个五年项目，具有预期的 收集919例连续肝移植的详细临床资料 在三个主要中心演出。通过合并资源利用率 与有限责任公司的数据库，关于决定因素的重要信息 将获得肝移植费用的百分比。具体目标 这个项目的主要内容是：1)开发数学模型来预测 基于受体的原位肝移植(OLT)费用 移植前的临床和人口统计学特征2)以确定 不同器官分配方案对肝脏成本的影响 移植。 我们将采用三种策略来分析这些数据。一旦成本数据 已与临床数据合并，单变量和多变量 将进行分析以确定哪些临床特征是 与增加的OLT成本相关。第二，将构建模型 它可以根据特定的临床特征预测原位肝移植的成本。 最后，使用这些模型，我们将确定 不同的器官分配方案。 这些研究将为这一耗资巨大的 对终末期肝病的有效治疗。通过理解 影响成本的因素我们希望能够更好地评估新的 治疗，评估和修改我们目前的器官分配系统， 并使肝移植更具成本效益。

The goal of this proposal is to identify factors which determine the cost of liver transplantation. Our center has participated in the NIDDK Liver Transplant Database (LTD), a five year project which has prospectively collected detailed clinical data on 919 consecutive liver transplants performed at three major centers. By merging a resource utilization database with the LTD, important information regarding the determinants of the cost of liver transplantation will be obtained. The specific aims of this project are: 1) To develop mathematical models which predict the cost of orthotopic liver transplantation (OLT) based on the recipient's pre-transplant clinical and demographic profile 2) To determine the impact of different organ allocation schemes on the cost of liver transplantation. Three strategies will be employed to analyze the data. Once the cost data has been merged with the clinical data, univariate and multi-variate analyses will be performed to identify clinical features which are associated with increased cost of OLT. Second, models will be constructed which can predict the cost of OLT based on a specific clinical profile. Finally, using these models, we will determine the economic impact of different schemes of organ allocation. These studies will provide important insights into this costly yet effective therapy for end-stage liver disease. By understanding the factors that influence costs we hope to be able to better evaluate new therapies, evaluate and modify our current system of organ allocation, and make liver transplantation more cost effective.