Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality?

Research output: Contribution to journalArticle

John R. Montgomery, Alexandra Highet, Mark J. Hobeika, Michael J. Englesbe, Lisa M. McElroy

Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers.

Original languageEnglish (US)
Article numbere13780
JournalClinical Transplantation
Volume34
Issue number2
DOIs
StatePublished - Feb 1 2020

PMID: 31903648

Altmetrics

Cite this

Standard

Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality? / Montgomery, John R.; Highet, Alexandra; Hobeika, Mark J.; Englesbe, Michael J.; McElroy, Lisa M.

In: Clinical Transplantation, Vol. 34, No. 2, e13780, 01.02.2020.

Research output: Contribution to journalArticle

Harvard

Montgomery, JR, Highet, A, Hobeika, MJ, Englesbe, MJ & McElroy, LM 2020, 'Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality?' Clinical Transplantation, vol. 34, no. 2, e13780. https://doi.org/10.1111/ctr.13780

APA

Montgomery, J. R., Highet, A., Hobeika, M. J., Englesbe, M. J., & McElroy, L. M. (2020). Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality? Clinical Transplantation, 34(2), [e13780]. https://doi.org/10.1111/ctr.13780

Vancouver

Montgomery JR, Highet A, Hobeika MJ, Englesbe MJ, McElroy LM. Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality? Clinical Transplantation. 2020 Feb 1;34(2). e13780. https://doi.org/10.1111/ctr.13780

Author

Montgomery, John R. ; Highet, Alexandra ; Hobeika, Mark J. ; Englesbe, Michael J. ; McElroy, Lisa M. / Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality?. In: Clinical Transplantation. 2020 ; Vol. 34, No. 2.

BibTeX

@article{46f30834e43c4cba9c686e12a58e4873,
title = "Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality?",
abstract = "Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers.",
keywords = "deceased after brain death, deceased after circulatory death, donation, liver, reimbursement, travel",
author = "Montgomery, {John R.} and Alexandra Highet and Hobeika, {Mark J.} and Englesbe, {Michael J.} and McElroy, {Lisa M.}",
year = "2020",
month = "2",
day = "1",
doi = "10.1111/ctr.13780",
language = "English (US)",
volume = "34",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley",
number = "2",

}

RIS

TY - JOUR

T1 - Going the distance for procurement of donation after circulatory death livers for transplantation—Does reimbursement reflect reality?

AU - Montgomery, John R.

AU - Highet, Alexandra

AU - Hobeika, Mark J.

AU - Englesbe, Michael J.

AU - McElroy, Lisa M.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers.

AB - Donation after circulatory death (DCD) liver transplantation (LT) has increased slowly over the past decade. Given that transplant surgeons generally determine liver offer acceptance, understanding surgeon incentives and disincentives is paramount. The purpose of this study was to assess aggregate travel distance per successful DCD versus deceased after brain death (DBD) liver procurement as a surrogate for surgeon time expenditure and opportunity cost. All consecutive liver offers made to Michigan Medicine from 2006 to 2017 were analyzed. Primary outcome was the summative travel distance (spent on all attempted procurements) per successful liver procurement that resulted in LT. Donation after circulatory death liver offer acceptance was lower than DBD liver offers, as was proportion of successful procurements among accepted offers. Overall, 10 275 miles were travelled for accepted DCD liver offers, resulting in 23 successful procurements (mean 447 miles per successful DCD liver procurement). For accepted DBD liver offers, 197 299 miles were travelled, resulting in 863 successful procurements (mean 229 miles per successful DBD liver procurement). On average, each successful DCD liver procurement required 218 more miles of travel than each successful DBD liver procurement. Current reimbursement policies poorly reflect increased surgeon travel (and time) expenditures between DCD and DBD liver offers.

KW - deceased after brain death

KW - deceased after circulatory death

KW - donation

KW - liver

KW - reimbursement

KW - travel

UR - http://www.scopus.com/inward/record.url?scp=85078793843&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85078793843&partnerID=8YFLogxK

U2 - 10.1111/ctr.13780

DO - 10.1111/ctr.13780

M3 - Article

VL - 34

JO - Clinical Transplantation

T2 - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 2

M1 - e13780

ER -

ID: 60123042