J Korean Soc Transplant.  2017 Dec;31(4):193-199. 10.4285/jkstn.2017.31.4.193.

Initiating Liver Transplantation at a Public Hospital in Korea

• Lee DH
• Lee HW
• Ahn YJ
• Kim H
• Yi NJ
• Lee KW
• Suh KS

• KMID: 2401570
• DOI: http://doi.org/10.4285/jkstn.2017.31.4.193

Abstract

BACKGROUND
Although there more than 1,000 liver transplantations (LTs) are performed in Korea annually, their immense cost remains a great hurdle. Hence, in an attempt to reduce the medical costs of LT, a program was initiated at a public hospital affiliated with the Seoul National University Hospital.
METHODS
A total of 11 LTs have been successfully executed since the first LT performed at Seoul Metropolitan Government Seoul National University Boramae Medical Center in July 2011 through December 2014.
RESULTS
Nine patients (81.8%) were male and two (18.2%) were female. The mean age of patients was 53.4±11.4 years. Hepatitis B virus-related liver disease (n=6, 54.5%) was the most common causative disease, followed by alcoholic liver disease (ALD) (n=4,36.4%). The actuarial 3-year survival rate was 90.9%. The median total medical cost of LTs was US $41,583 (calculated from operation to discharge), but only $11,860 was actually charged for patients with health insurance coverage. One female patient who had undergone deceased donor LT for alcoholic liver cirrhosis died during follow-up. This patient was non-compliant with the medical instructions after discharge, and finally expired due to septic shock at 10 months post-LT.
CONCLUSIONS
In the public hospital, LT was successfully performed at a much lower cost. However, LT guidelines and peritransplant management protocols for patients with ALD must be established before escalating LT at public hospitals since ALD with poor compliance is one of the most common causes of complications at public hospitals.

Keyword

Liver transplantation; Public hospital; Medical cost; Alcoholic liver disease

MeSH Terms

Compliance
Female
Follow-Up Studies
Hepatitis B
Hospitals, Public*
Humans
Insurance, Health
Korea*
Liver Cirrhosis, Alcoholic
Liver Diseases
Liver Diseases, Alcoholic
Liver Transplantation*
Liver*
Local Government
Male
Seoul
Shock, Septic
Survival Rate
Tissue Donors

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