Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality (2024)

Yang, Z., Gerull, W. D., Gauthier, J. M., Meyers, B. F., Kozower, B. D., Patterson, G. A., Nava, R. G., Hachem, R. R., Witt, C. A., Byers, D. E., Marklin, G. F., Ridolfi, G., Liu, J., Kreisel, D., & Puri, V. (2020). Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality. Annals of Thoracic Surgery, 110(5), 1691-1697. https://doi.org/10.1016/j.athoracsur.2020.04.086

Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality. / Yang, Zhizhou; Gerull, William D.; Gauthier, Jason M. et al.
In: Annals of Thoracic Surgery, Vol. 110, No. 5, 11.2020, p. 1691-1697.

Research output: Contribution to journal › Article › peer-review

Yang, Z, Gerull, WD, Gauthier, JM, Meyers, BF, Kozower, BD, Patterson, GA, Nava, RG, Hachem, RR, Witt, CA, Byers, DE, Marklin, GF, Ridolfi, G, Liu, J, Kreisel, D & Puri, V 2020, 'Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality', Annals of Thoracic Surgery, vol. 110, no. 5, pp. 1691-1697. https://doi.org/10.1016/j.athoracsur.2020.04.086

Yang Z, Gerull WD, Gauthier JM, Meyers BF, Kozower BD, Patterson GA et al. Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality. Annals of Thoracic Surgery. 2020 Nov;110(5):1691-1697. doi: 10.1016/j.athoracsur.2020.04.086

Yang, Zhizhou ; Gerull, William D. ; Gauthier, Jason M. et al. / Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality. In: Annals of Thoracic Surgery. 2020 ; Vol. 110, No. 5. pp. 1691-1697.

@article{ea931438d96c4c4d99f84474747007d5,

title = "Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality",

abstract = "Background: On November 24, 2017, a change in lung allocation policy was initiated to replace the donor service area with a 250-nautical-mile radius circle around the donor hospital. We aim to analyze the consequences of this change, including organ acquisition cost and transplant outcomes, at the national level. Methods: Data on adult patients undergoing lung transplantation between April 27, 2017, and June 22, 2018 (30 weeks before to 30 weeks after allocation policy change) were extracted from the Scientific Registry of Transplant Recipients database. Patients were classified into pre-change and post-change subgroups. Six-month overall survival was evaluated by Kaplan-Meier analysis. Organ acquisition costs were compared between the pre-change and post-change groups. Results: Of the 3317 adult patients removed from the waiting list during the study period (pre-change 1637 vs post-change 1680), 2734 underwent transplantation (pre-change 1371 of 1637 [83.8%] vs post-change 1363 of 1680 [81.1%]), and 382 died or became too sick to be transplanted (pre-change 168 of 1637 [10.3%] vs post-change 214 of 1680 [12.7%], P = .077). Six-month survival rates of transplanted patients were similar between the two groups. However, average organ acquisition costs increased after policy change (pre-change $50,735 ± $10,858 vs post-change $53,440 ± $10,247, P < .001) with an increase in nonlocal donors (pre-change 44.3% vs post-change 68.9%, P < .001). Conclusions: Organ acquisition costs and resource utilization increased with the new lung allocation policy, whereas deaths on the waiting list or after transplantation did not decrease. Further optimization of the allocation policy is necessary to balance access to transplant and proper stewardship of human and financial resources.",

author = "Zhizhou Yang and Gerull, {William D.} and Gauthier, {Jason M.} and Meyers, {Bryan F.} and Kozower, {Benjamin D.} and Patterson, {G. Alexander} and Nava, {Ruben G.} and Hachem, {Ramsey R.} and Witt, {Chad A.} and Byers, {Derek E.} and Marklin, {Gary F.} and Gene Ridolfi and Jingxia Liu and Daniel Kreisel and Varun Puri",

note = "Publisher Copyright: {\textcopyright} 2020 The Society of Thoracic Surgeons",

year = "2020",

month = nov,

doi = "10.1016/j.athoracsur.2020.04.086",

language = "English (US)",

volume = "110",

pages = "1691--1697",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "Elsevier USA",

number = "5",

}

TY - JOUR

T1 - Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality

AU - Yang, Zhizhou

AU - Gerull, William D.

AU - Gauthier, Jason M.

AU - Meyers, Bryan F.

AU - Kozower, Benjamin D.

AU - Patterson, G. Alexander

AU - Nava, Ruben G.

AU - Hachem, Ramsey R.

AU - Witt, Chad A.

AU - Byers, Derek E.

AU - Marklin, Gary F.

AU - Ridolfi, Gene

AU - Liu, Jingxia

AU - Kreisel, Daniel

AU - Puri, Varun

N1 - Publisher Copyright:© 2020 The Society of Thoracic Surgeons

PY - 2020/11

Y1 - 2020/11

N2 - Background: On November 24, 2017, a change in lung allocation policy was initiated to replace the donor service area with a 250-nautical-mile radius circle around the donor hospital. We aim to analyze the consequences of this change, including organ acquisition cost and transplant outcomes, at the national level. Methods: Data on adult patients undergoing lung transplantation between April 27, 2017, and June 22, 2018 (30 weeks before to 30 weeks after allocation policy change) were extracted from the Scientific Registry of Transplant Recipients database. Patients were classified into pre-change and post-change subgroups. Six-month overall survival was evaluated by Kaplan-Meier analysis. Organ acquisition costs were compared between the pre-change and post-change groups. Results: Of the 3317 adult patients removed from the waiting list during the study period (pre-change 1637 vs post-change 1680), 2734 underwent transplantation (pre-change 1371 of 1637 [83.8%] vs post-change 1363 of 1680 [81.1%]), and 382 died or became too sick to be transplanted (pre-change 168 of 1637 [10.3%] vs post-change 214 of 1680 [12.7%], P = .077). Six-month survival rates of transplanted patients were similar between the two groups. However, average organ acquisition costs increased after policy change (pre-change $50,735 ± $10,858 vs post-change $53,440 ± $10,247, P < .001) with an increase in nonlocal donors (pre-change 44.3% vs post-change 68.9%, P < .001). Conclusions: Organ acquisition costs and resource utilization increased with the new lung allocation policy, whereas deaths on the waiting list or after transplantation did not decrease. Further optimization of the allocation policy is necessary to balance access to transplant and proper stewardship of human and financial resources.

AB - Background: On November 24, 2017, a change in lung allocation policy was initiated to replace the donor service area with a 250-nautical-mile radius circle around the donor hospital. We aim to analyze the consequences of this change, including organ acquisition cost and transplant outcomes, at the national level. Methods: Data on adult patients undergoing lung transplantation between April 27, 2017, and June 22, 2018 (30 weeks before to 30 weeks after allocation policy change) were extracted from the Scientific Registry of Transplant Recipients database. Patients were classified into pre-change and post-change subgroups. Six-month overall survival was evaluated by Kaplan-Meier analysis. Organ acquisition costs were compared between the pre-change and post-change groups. Results: Of the 3317 adult patients removed from the waiting list during the study period (pre-change 1637 vs post-change 1680), 2734 underwent transplantation (pre-change 1371 of 1637 [83.8%] vs post-change 1363 of 1680 [81.1%]), and 382 died or became too sick to be transplanted (pre-change 168 of 1637 [10.3%] vs post-change 214 of 1680 [12.7%], P = .077). Six-month survival rates of transplanted patients were similar between the two groups. However, average organ acquisition costs increased after policy change (pre-change $50,735 ± $10,858 vs post-change $53,440 ± $10,247, P < .001) with an increase in nonlocal donors (pre-change 44.3% vs post-change 68.9%, P < .001). Conclusions: Organ acquisition costs and resource utilization increased with the new lung allocation policy, whereas deaths on the waiting list or after transplantation did not decrease. Further optimization of the allocation policy is necessary to balance access to transplant and proper stewardship of human and financial resources.

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U2 - 10.1016/j.athoracsur.2020.04.086

DO - 10.1016/j.athoracsur.2020.04.086

M3 - Article

C2 - 32511997

AN - SCOPUS:85092896704

SN - 0003-4975

VL - 110

SP - 1691

EP - 1697

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 5

ER -