Cost Analysis of Acute Rejection in Liver Transplanted Patients

Aim: Liver transplantation (LT) is the only definitive treatment for end-stage liver disease. Graft rejection is also an important complication of LT due to its high economic burden. In this descriptive study, we aimed to explore complications of liver transplantation, cost of graft rejection and identify factors associated with this complication. Methods: A total of 455 liver transplantations were performed between 1998 and 2016 in a University Hospital, in Turkey. Among these 455 patients, 43 patients with an episode of acute graft rejection which were documented histologically by using Banff Schema were selected for this retrospective study. The cost of hospitalization during graft rejection period were recorded as specific cost associated factors such as intensive care unit, dialysis, blood bank, laboratory, radiology, medications and medical equipment. Results: The mean cost of acute graft rejection was 12423,74 (315,00-61236,94) American Dollars. Most important components of the total cost were medications, laboratory and medical equipment. The cost of acute rejection was independent of United Network for Organ Share (UNOS), (p:0.928), Model for End-stage Liver Disease (MELD) (p:0.935) scores, type of donation (p:0.976), age (p:0.464) and gender (p:0.584) of the patient. Conclusion: The cost of acute graft rejection is independent of the patients’ characteristics. The importance of this study is that it is the first study of cost analysis among liver transplanted patients with an episode of acute rejection in Turkey which are very rare studies throughout the world Keywords: liver transplantation, rejection, cost analysis.