The cost-effectiveness of organ preservation methods in renal transplantation: US projections based on the machine preservation trial.

Abstract

INTRODUCTION:

The European Machine Preservation Trial (MPT) found a significantly lower rate of delayed graft function and improved graft survival in machine-perfused kidneys compared to cold-stored kidneys in the first year following kidney transplantation. Little is known about the cost-effectiveness of various organ preservation methods.

METHODS:

Outcome data from the MPT have been used to conduct a comparative cost-effectiveness analysis based on preservation method for both standard criteria (SCD) and expanded criteria donor (ECD) kidney transplants in the United States. Using graft survival as the primary outcome measure, a cost-effectiveness model was developed using Medicare and private payer cost/payment data, as well as clinical transition probabilities based on the MPT and other studies.

RESULTS:

At 1-year posttransplant, machine perfusion is a more cost-effective option than cold storage for organ preservation in transplants involving either SCD ($92,561 vs $104,118) or ECD ($106,012 vs $114,530) kidneys. Moreover, the cost-effectiveness ratios for transplants involving machine-perfused ECD kidneys ($106,012) are similar to those for transplants using cold-stored SCD kidneys ($104,118).

CONCLUSION:

Machine perfusion is preferable to cold storage for organ preservation in both SCD and ECD donor kidney transplants. Not only is it more cost-effective, but from all relevant perspectives it adds substantial value.

• Authors: S S Garfield, A W Poret, R W Evans
• Journal: Transplantation proceedings (Transplant Proc) Vol. 41 Issue 9 Pg. 3531-6 (Nov 2009) ISSN: 1873-2623 [Electronic] United States
• PMID: 19917339 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Cost-Benefit Analysis
• Graft Survival
• Humans
• Kidney Transplantation (economics)
• Organ Preservation (economics, instrumentation, methods)
• Postoperative Complications (economics)
• Probability
• Renal Replacement Therapy (economics)
• Tissue Donors (statistics & numerical data)
• Treatment Outcome
• United States