Cost-utility of living donor liver transplantation in a single Japanese center.

BACKGROUND/AIMS: Living donor liver transplantation is becoming increasingly important in the Western world, but the economic issues remain controversial. We conducted a cost-utility analysis to evaluate whether living donor liver transplantation is cost-effective. METHODOLOGY: Cost and utility analyses were performed in a longitudinal survey of a single center in Sapporo, Japan. Medical costs were derived from 11 patients who underwent living donor liver transplantation. Health utility was measured in quality-adjusted life year. Data for health utility scores were derived from 19 patients who underwent living donor liver transplantation. RESULTS: Median medical cost was U.S. dollars 154,626 from the first day of preoperative evaluation to 24 months post-transplantation. Cumulative quality-adjusted life years were 1.60 at 24 months after transplantation. Medical cost per quality-adjusted life year decreased progressively, leading to medical cost of U.S. dollars 605,131 per quality-adjusted life year at 3 months to U.S. dollars 94,169 at 24 months after transplantation. The results were sensitive to medical cost. CONCLUSIONS: Follow-up survey identified progressive increases in the cost-effectiveness of living donor liver transplantation for patients with end-stage liver disease. Living donor liver transplantation appears to represent a cost-effective medical technology.