Clinical outcomes, quality of life, and cost outcomes after cardiac transplantation.
Cardiac transplantation improves survival in patients with advanced heart failure, especially those who are dependent on intravenous inotropic support or mechanical assistance. However, cardiac transplantation remains a treatment modality rather than a curative procedure, and thus, necessitates long-term care and indefinite immunosuppression. Although quality of life is improved for most cardiac transplant recipients, concerted effort is necessary for long-term care and follow-up of the transplanted heart. The economics of cardiac transplantation are receiving increased scrutiny, especially because of the increasing pretransplant hospital expenditures that have resulted from transplantation in more patients in the hospital who require intravenous inotropic support or mechanical devices. This shift ultimately is related to the reduced supply of donors relative to the demand. The ultimate impact of managed care on cardiac transplantation is not clear, but it probably will continue to reduce expenditures in the near term.
Hershberger
R E
RE
Division of Medicine/Cardiology, Heart Failure and Transplant Cardiology, Oregon Health Sciences University, Portland 97201, USA. hershber@ohsu.edu
D003363:Cost Control; D003365:Costs and Cost Analysis; D003710:Demography; D004651:Employment; D006331:Heart Diseases / Q000401:mortality / Q000628:therapy*; D016027:Heart Transplantation / Q000191:economics* / Q000401:mortality; D006801:Humans; D008329:Managed Care Programs; D015337:Multicenter Studies as Topic; D011788:Quality of Life; D012046:Rehabilitation; D016019:Survival Analysis; D014019:Tissue Donors; D016896:Treatment Outcome; D014481:United States