Early Allograft Dysfunction Is Associated With Excess Resource Utilization After Liver Transplantation

Background. There are limited data on length of stay (LOS) following liver transplantation (LT), yet this is an important health services metric that directly correlates with early post-LT health care costs. The primary objective of this study was to examine the relationship between early allograft dysfunction (EAD) and LOS after LT. The secondary objective was to identify additional recipient, donor, and operative factors associated with LOS. Methods. Adult patients undergoing primary LT over a 32-month period were prospectively examined at a single center. Subjects fulfilling standard criteria for EAD were compared with those not meeting the definition. Variables associated with increased LOS on ordinal logistic regression were identified. Results. Subjects with EAD had longer mean hospital LOS than those without (42.5 +/- 38.9 days vs 27.4 +/- 31 days; P = .003). Subjects with BAD also had longer mean intensive care LOS (8.61 +/- 10.28 days vs 5.45 +/- 11.6 days; P = .048). Additional factors significantly associated with LOS included Model for End-Stage Liver Disease (MELD) score, recipient location before LT, and postoperative surgical complications. Conclusions. BAD is associated with longer hospitalization after LT. MELD score, preoperative recipient location, and postoperative complications were significantly associated with LOS. From a cost-containment perspective, these findings have implications on resource allocation.