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Cost-utility of living donor liver transplantation in a single Japanese center.

BACKGROUND/AIMS
Living donor liver transplantation is becoming increasingly important in the Western world, but the economic issues remain controversial. We conducted a cost-utility analysis to evaluate whether living donor liver transplantation is cost-effective.


METHODOLOGY
Cost and utility analyses were performed in a longitudinal survey of a single center in Sapporo, Japan. Medical costs were derived from 11 patients who underwent living donor liver transplantation. Health utility was measured in quality-adjusted life year. Data for health utility scores were derived from 19 patients who underwent living donor liver transplantation.


RESULTS
Median medical cost was U.S. dollars 154,626 from the first day of preoperative evaluation to 24 months post-transplantation. Cumulative quality-adjusted life years were 1.60 at 24 months after transplantation. Medical cost per quality-adjusted life year decreased progressively, leading to medical cost of U.S. dollars 605,131 per quality-adjusted life year at 3 months to U.S. dollars 94,169 at 24 months after transplantation. The results were sensitive to medical cost.


CONCLUSIONS
Follow-up survey identified progressive increases in the cost-effectiveness of living donor liver transplantation for patients with end-stage liver disease. Living donor liver transplantation appears to represent a cost-effective medical technology.