OBJECTIVES:

Liver transplantation (LT) is expensive. Recipients require lifelong care, which increases the burden of transplantation. This study aimed to estimate the hospitalization costs and following costs of LT surgery in young patients.

METHODS:

This study was conducted using the national claims data of the Health Insurance Review and Assessment Service covering the entire population in Korea. Patients who had received LT surgery (procedure code of Q80*) between January 1, 2008 and October 31, 2018 were included. To estimate post-LT costs, we only selected patients with at least three years of follow-up after discharge. Young patients were defined as those under 20 years of age. The LT cost was calculated as the medical expenses incurred from the time the patient was hospitalized for surgery until discharge. Post-LT costs were analyzed in the claims data with ICD-10 code Z94.4 (Liver transplant status) and measured annual medical expenses incurred from the day after discharge to the following year. We investigated medical expenses up to the third year. Costs were estimated without excluding patients who died postoperatively.

RESULTS:

We identified 579 recipients of liver transplantation (mean age 5.4 years, median age 2.0 years, 57% of females). The most common indication for LT in young patients was bile duct atresia. The cost of LT was USD 50,909 per patient. The annual costs of the first, second, and third years after LT surgery were USD 12,437, USD 6,753, and USD 4,837, respectively.

CONCLUSIONS:

This study presents the post-LT costs that have not previously been reported in young patients. Even three years after the surgery, there were still high medical expenses. It is necessary to reduce the following healthcare costs by finding ways to maximize the benefits of liver transplantation.