US Projections Based on the Machine Preservation Trial

Garfield SS, Poret AW, Evans RW. The Cost-Effectiveness of Organ Preservation Methods in Renal Transplantation: US Projections Based on the Machine Preservation Trial. Trans Proc 2009;41:3531-3536

The Machine Preservation Trial was the first prospective, international randomized controlled trial comparing machine perfusion on LifePort with static cold storage.1

Rationale – Retrospective studies have suggested that machine preservation may be associated with lower costs of transplantation.2

Study design – 336 kidney pairs (672 recipients) were included in the Machine Preservation Trial. Kidney pairs were from consecutive donors and all commonly-used deceased-donor kidney types were included. From each donor pair, one kidney was randomized to machine perfusion with LifePort and the other to static cold storage. The trial was conducted in the North Rhine-Westphaliarenal Region of Germany, The Netherlands, and Belgium in collaboration with Eurotransplant and the Deutsche Stiftung Organ transplantation. Outcome data from the Machine Preservation Trial were used to conduct a cost-effectiveness analysis based on preservation method for both SCD and ECD kidney transplants in the US. The model used graft survival at one year as the primary outcome measure when determining cost-effectiveness.

Key economic data (machine preservation with LifePort vs static cold storage) In the economic analysis, compared with static cold storage, machine perfusion with LifePort:

• Is more cost-effective for SCD kidney transplants ($92,561 vs. $104,118)
• Is more cost-effective for ECD kidney transplants ($106,012 vs. $114,530)
• Has cost-effectiveness ratios for ECD kidney transplants similar to cold-stored SCD kidney transplants ($106,012 vs. $104,118)

Read the paper (subscription required for full-text): The Cost-Effectiveness of Organ Preservation Methods in Renal Transplantation: US Projections Based on the Machine Preservation Trial

References

1. Moers C, Smits JM, Maathius MH, et al. Machine Perfusion or Cold Storage in Deceased-Donor Kidney Transplantation. N Engl J Med 2009;360:7-19
2. Buchanan PM, Lentine KL, Burroughs TE, et al. Association of lower costs of pulsatile machine perfusion in renal transplantation from expanded criteria donors. Am J Transplant 2008;8:2391-2401