{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:24:00Z","timestamp":1791397440514,"version":"4.3.3"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Early liver transplantation (LT) for severe alcoholic hepatitis (AH) is a rescue therapy for highly selected patients with favorable psychosocial profiles not responding to medical therapy. Given the expected increase of AH candidate referrals requiring complex care and comprehensive evaluations, increased workload and cost might be expected from implementing an early LT program for AH but have not been determined. Some centers may also view AH as a strategy to expeditiously increase LT volume and economic viability. The aim of this study was to determine the health care use and costs of an early LT program for AH. Analyses of prospective databases of AH, interhospital transfers, and the hospital accounting system at a single center were performed from July 2011 to July 2016. For 5\u00a0years, 193 patients with severe AH were evaluated at our center: 143 newly referred transfers and 50 direct admissions. Annual increases of 13% led to 2 to 3 AH transfers\/month and AH becoming the top reason for transfer. There were 169 (88%) nonresponders who underwent psychosocial evaluations; 15 (9%) underwent early LT. The median cost of early LT was $297,422, which was highly correlated with length of stay (<jats:italic toggle=\"yes\">r<\/jats:italic>\u00a0=\u00a00.83; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). Total net revenue of the program from LT admission to 90\u00a0days after LT was \u2212$630,305 (\u22125.0% revenue), which was inversely correlated with MELD score (<jats:italic toggle=\"yes\">r<\/jats:italic>\u00a0=\u00a0\u22120.70; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.004) and yielded lower revenue than a contemporaneous LT program for acute\u2010on\u2010chronic liver failure (ACLF; $118,168; 1.4% revenue; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001). The health care use and costs of an early LT program for AH are extensive and lifesaving with marginally negative net revenue. Significantly increasing care of severe AH patients over 5 years resulted in increased LT volume, but at a lower rate than ACLF, and without improving economic outcomes due to high MELD and prolonged length of stay.<\/jats:p>","DOI":"10.1002\/lt.26215","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T13:42:00Z","timestamp":1623850920000},"page":"27-38","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":27,"title":["Extensive Health Care Utilization and Costs of an Early Liver Transplantation Program for Alcoholic Hepatitis"],"prefix":"10.1097","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0009-8418","authenticated-orcid":false,"given":"Gene Y.","family":"Im","sequence":"first","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4009-7308","authenticated-orcid":false,"given":"Alexander S.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Florman","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Abdominal Transplantation, Department of Surgery,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Nahas","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Aqui","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ford","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Mirza","sequence":"additional","affiliation":[{"name":"Department of Psychiatry,The Mount Sinai Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leona","family":"Kim\u2010Schluger","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Schiano","sequence":"additional","affiliation":[{"name":"Recanati\/Miller Transplantation Institute, Division of Liver Diseases, Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,7]]},"reference":[{"key":"lt26215-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1056\/NEJMoa1105703","article-title":"Early liver transplantation for severe alcoholic hepatitis","volume":"365","year":"2011","journal-title":"N Engl J 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