Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Curr Opin Organ Transplant. 2013 Apr;18(2):222-8. doi: 10.1097/MOT.0b013e32835f0757.
Organ transplant is a resource-intensive service that has been subjected to increasing scrutiny in this era of cost containment. A detailed understanding of the economic (societal) and financial (transplant provider) implications of organ quality, recipient characteristics, and allocation policy is vital for the transplant professionals.
Prior studies of kidney transplant economics demonstrate significant cost savings achieved by eliminating the need for long-term dialysis. However, transplant providers are experiencing higher financial costs because of changes in recipient characteristics and broader use of marginal organs. Liver transplantation economics are also more challenging because of the severity of illness-based organ allocation. Furthermore, the use of more allografts recovered from donors after cardiac death has been demonstrated to increase costs with minimal benefits. Finally, successful long-term mechanical support devices have fundamentally changed the economic implications of advanced heart failure care.
Although care for end-stage organ failure through transplant is one of the landmark accomplishments of 20th century medicine, maintaining or expanding access to transplant care is threatened by the high cost of care. Novel strategies are vital to reduce the financial burden faced by the centers that transplant high-risk patients and utilize lower quality organs.
器官移植是一项资源密集型服务，在成本控制时代受到越来越多的审查。详细了解器官质量、受者特征和分配政策的经济（社会）和财务（移植提供者）影响，对于移植专业人员至关重要。
先前对肾移植经济学的研究表明，通过消除长期透析的需要，可以实现显著的成本节约。然而，由于受者特征的变化和边缘器官的广泛使用，移植提供者正面临更高的财务成本。由于基于疾病严重程度的器官分配，肝移植经济学也更加具有挑战性。此外，已经证明使用更多来自心脏死亡供者的同种异体移植物会增加成本，而获益甚微。最后，成功的长期机械支持设备从根本上改变了晚期心力衰竭治疗的经济影响。
尽管通过移植治疗终末期器官衰竭是 20 世纪医学的里程碑式成就之一，但由于护理成本高昂，维持或扩大移植护理的机会受到威胁。对于移植高风险患者和利用低质量器官的中心来说，降低财务负担的新策略至关重要。
