title: Influence on ICU course, outcome and costs for lung transplantation after implementation of the new Swiss transplantation law.
abstract: BACKGROUND
  The Swiss organ allocation system for donor lungs was implemented on 1 July 2007. The effects of this implementation on patient selection, intensive care unit course, outcomes and intensive care costs are unknown.
  
  
  METHODS
  The first 37 consecutive lung transplant recipients following the implementation of the new act were compared with the previous 42 lung transplant recipients.
  
  
  RESULTS
  Following implementation of the new law, baseline characteristics and cumulative one-year patient survival were comparable in both groups (88.1% vs 83.8%, P = 0.58). The costs for each case increased by 35,000 euros after adoption of the new law. Stratifying patients after implementation of the law according to urgency status shows that urgent patients required longer mechanical ventilation (P = 0.04), a longer ICU stay (P = 0.045) and a longer hospital stay (P = 0.04) and ICU costs (median 64,050 euros) were higher compared to regular patients.
  
  
  CONCLUSIONS
  The new transplantation law has increased ICU costs with the implementation of the Swiss organ allocation system. Patients listed as 'urgent' contribute significantly to the increase in ICU costs.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Klinzing
authors.forename: Giovanna
authors.initials: G
authors.lastname: Brandi
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Raptis
authors.forename: Urs
authors.initials: U
authors.lastname: Wenger
authors.forename: Denise
authors.initials: D
authors.lastname: Weber
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stehberger
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland. markus.bechir@paraplegie.ch.
authors.forename: Markus
authors.initials: M
authors.lastname: Béchir