An abstract presented at the American Transplant Congress (ATC) in May 2013 by Dr. Victoria Gomez et al. evaluated the budgetary impact and incremental cost-effectiveness of hypothermic machine perfusion compared with static cold storage.1
Kidneys transplanted from expanded criteria donors (ECDs) have a significantly increased incidence of delayed graft function (DGF) compared with kidneys from standard criteria donors,2 which increases post-operative costs due to prolonged hospital stay, the need for dialysis and additional diagnostic procedures.
The short-term cost-effectiveness of ECD transplantation using machine perfusion was reviewed using a probabilistic theoretical decision-tree. The budgetary impact and incremental cost-effectiveness ratio was estimated in terms of the number of DGF and primary non-function (PNF) cases saved by using machine perfusion instead of static cold storage.
The budgetary impact per patient of using machine perfusion was €610, but the incremental cost-effectiveness ratio showed a €16,476 saving for each case of initial graft function achieved. With published data showing that machine perfusion reduces the risk of DGF and PNF compared with static cold storage,3 this study has shown that machine perfusion is a cost effective option despite the initial budgetary impact.
1. Gomez V et al. Economic impact of pulsatile hypothermic perfusion in an expanded criteria donor transplant program. Analysis of the first year since its introduction. Abstract presented at American Transplant Congress, Seattle USA, May 18–22, 2013.
2. Johnson TD et al. Sensitivity of expanded-criteria donor kidneys to cold ischemia time. Clin Transpl 2004;18:28–32.
3. Moers C et al. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med 2009;360:7–19.
Check out the most recent posts
July 29, 2022 to August 3, 2022 San Diego, CA Produced by the Transplant Life Foundation, the Transplant Games honor the lasting legacy of donors who gave the ultimate gift of life, highlight the need for and importance of organ, eye, and tissue donation, celebrate...
HMP of Kidneys Compensates for Extended Storage Time: A Single Intervention With a Significant Impact
A study out of Poland by Kruszyna and Richter sought to determine whether with increased cold ischemic times (CIT) and increased use of extended criteria donors (ECD), would hypothermic machine perfusion (HMP) still have the potential to improve outcomes in kidney...
In a multicenter, randomized, controlled trial by Van Rijn, et al, they sought to compare hypothermic oxygenated machine perfusion with static cold storage in liver transplantation from donation after cardiac death (DCD) donors. In this trial, they included 156...
A multicenter retrospective study by de Sandes-Freitas et al. sought to determine the national rate of delayed graft function (DGF) and the associated risk factors with DGF. They studied 8,657 single deceased donor kidney transplants between January 2014 and December...