Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Department of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Transplantation. 2022 Jun 1;106(6):1201-1205. doi: 10.1097/TP.0000000000003958. Epub 2022 Sep 23.
Living liver donation is generally considered safe, but donors may experience short- or long-term complications. The purpose of this study was to assess healthcare resource utilization after liver donation in living liver donors in comparison with the general population.
Outpatient or emergency department visits and hospital admissions were compared between living liver donors who underwent hepatic resection for living liver donation between 2004 and 2018 and the matched general population. Healthcare resource utilization data for 5 y after liver donation were collected from the National Health Insurance Service database. For every living liver donor, 4 individually matched nondonors were selected from the National Health Insurance Service database using age, sex, preexisting comorbidities, and previous healthcare utilization history.
A total of 1886 living liver donors and 7309 nondonors were included. In the first year after donation, living liver donors required more outpatient department visits (7 [4-13] versus 3 [1-7], P < 0.001) and more emergency department visits (13.33% versus 0.15%, P < 0.001) compared with matched nondonors. A similar trend persisted for 5 y after donation. The number of hospital admissions of living liver donors was higher for up to 2 y after donation with longer hospital length of stay (13.0 [10.5-16.0] d versus 5.0 [3.0-9.0] d, P < 0.0001).
Healthcare resource utilization in living liver donors for 5 y after donation was higher compared with matched nondonors. The higher healthcare resource demand may be related to postoperative complications or lowered threshold for healthcare resource utilization after donation.
活体肝移植通常被认为是安全的，但捐献者可能会出现短期或长期并发症。本研究旨在评估活体肝移植供体与普通人群相比，在肝移植后对医疗资源的利用情况。
比较了 2004 年至 2018 年间接受肝切除术的活体肝移植供体与匹配的普通人群之间的门诊或急诊就诊和住院情况。从国家健康保险服务数据库中收集了肝移植后 5 年的医疗资源利用数据。对于每一位活体肝移植供体，从国家健康保险服务数据库中选择了 4 位年龄、性别、既往合并症和既往医疗利用史相匹配的非供体。
共纳入 1886 名活体肝移植供体和 7309 名非供体。在捐赠后的第一年，活体肝移植供体需要更多的门诊就诊（7[4-13]次与 3[1-7]次，P<0.001）和更多的急诊就诊（13.33%与 0.15%，P<0.001）。这种趋势在捐赠后 5 年仍然存在。活体肝移植供体在捐赠后 2 年内的住院次数更高，住院时间更长（13.0[10.5-16.0]天与 5.0[3.0-9.0]天，P<0.0001）。
与匹配的非供体相比，活体肝移植供体在捐赠后 5 年内对医疗资源的利用更高。更高的医疗资源需求可能与术后并发症或捐赠后医疗资源利用的门槛降低有关。
