Costs associated with early vascular and biliary complications in liver-transplanted patients in a hospital in Antioquia, Colombia 2019: A cross-sectional study

Abstract

Objectives: Vascular and biliary complications associated with liver transplants involve high morbidity and mortality as well as cost overrun for health systems. Efforts to prioritize their prevention require not only clinical information but also information on costs that reflect the economic burden on health systems. The objective of this study was to describe cost overrun incurred from early vascular and biliary complications after liver transplant. Methods: This cross-sectional study included liver transplant patients treated at the San Vicente Foundation University Hospital, Rionegro – Antioquia, from January 1, 2013 to December 31, 2018. All liver transplant patients treated during the above period were included; the absence of clinical records on the variables of interest was considered as the exclusion criterion. A probabilistic analysis of patient cost was performed. Monte Carlo simulations as well as a one-way sensitivity analysis per transplant cost component were performed. Results: Records from 154 patients were assessed. The average patient age was 56.9 (SD 10.9) years; 42.9% patients were women. Of all, 36.4% patients were classified as Child C, and the average Model for End-Stage Liver Disease Score was 19.6. The average cost for patients without complications was $37,265.78, whereas that for patients with early vascular complications was $40,124,97 and for those with early biliary complications was $53,613.91. Conclusion: Early vascular and biliary complications after liver transplant increase health care costs, with the increase being significant in patients with biliary complications.