Sustainability of Lung Transplantation

The issue of accountability has striking administrative, social, and political perspectives in modern healthcare systems. The progress of technology, emerging diseases, and aging of the population are increasing the cost of providing adequate healthcare in both private payors and public systems worldwide. Organ transplantation and particularly lung transplantation are complex and expensive treatments that can cure end-stage organ disease. While many studies have tried to provide an estimate of all direct and indirect cost associated with lung transplantation, it is difficult to understand the cost-efficiency of the process. Many technical, ethical, and socioeconomic factors can play a role. There is an unmet need to obtain more precise data from the clinical pathways of transplant patients; accounting and finance control is of pivotal importance in hospitals. In this setting, the costs and benefits of all the relevant alternatives to transplantation need to be analyzed and understood. New but expensive drugs have changed the outcome of many aggressive pulmonary diseases that now can be managed without surgical intervention.