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Use of Machine Perfusion to Increase the Number of Expanded Criteria Deceased Donor Kidney Transplants: A Pharmacoeconomic Analysis.
Tedesco Silva, Helio; Ramos, Teresa Raquel de Moraes; de Carvalho, Deise De Boni Monteiro; Ferreira, Gustavo Fernandes; de Andrade, João Marcelo Medeiros; de Andrade, Luis Gustavo Modelli; Abbud-Filho, Mario; Foresto, Renato Demarchi; Manfro, Roberto Ceratti; Esmeraldo, Ronaldo de Matos; Freitas, Tainá Veras de Sandes; Garcia, Valter Duro; Pestana, José Medina; Fonseca, Marcelo Cunio Machado.
Afiliação
  • Tedesco Silva H; Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.
  • Ramos TRM; Disciplina de Nefrologia, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.
  • de Carvalho DBM; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.
  • Ferreira GF; Axia.Bio Life Sciences, São Paulo, Brazil.
  • de Andrade JMM; Axia.Bio Life Sciences, Miami, FL.
  • de Andrade LGM; Hospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil.
  • Abbud-Filho M; Transplant Unit Santa Casa Juiz de Fora, Juiz de Fora, Brazil.
  • Foresto RD; Unidade de Transplantes-Instituto de Medicina Integral Prof. Fernando Filgueira, Recife, Brazil.
  • Manfro RC; Universidade Estadual Paulista, Botucatu, Brazil.
  • Esmeraldo RM; Hospital de Base, Medical School FAMERP, São José do Rio Preto, Brazil.
  • Freitas TVS; Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.
  • Garcia VD; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Pestana JM; Hospital Geral de Fortaleza, Fortaleza, Brazil.
  • Fonseca MCM; Hospital Geral de Fortaleza, Fortaleza, Brazil.
Transplant Direct ; 10(8): e1668, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38988688
ABSTRACT

Background:

The discard of expanded criteria donor (ECD) kidneys is unacceptably high, considering the growing demand for transplantation. Using machine perfusion may reduce the discard rate, increase the number of transplants, and reduce mortality on the waiting list.

Methods:

We developed a 5-y Markov model to simulate incorporating the pulsatile perfusion machine into the current government-funded healthcare system. The model compared the universal use of static cold storage for all kidneys with the selective use of machine perfusion for ECD kidneys. Real-life data were used to compose the cohort characteristics in this model. This pharmacoeconomic analysis aimed to determine the cost-effectiveness and budgetary impact of using machine perfusion to preserve ECD kidneys.

Results:

Compared with the universal use of static cold storage, the use of machine perfusion for ECD kidneys was associated with an increase in the number of kidney transplants (n = 1123), a decrease in the number of patients on the waiting list (n = 815), and decrease in mortality (n = 120), with a cost difference of US dollar 4 486 009 in the period. The budget impact analysis revealed an additional cost of US dollar 4 453 749 >5 y. The budget impact analysis demonstrated a progressive reduction in costs, becoming cost-saving during the last year of the analysis.

Conclusions:

This stochastic model showed that incorporating machine perfusion for ECD kidneys is most often a dominant or cost-effective technology associated with an increase in the number of transplants and a reduction in the number of patients on the waiting list, reducing mortality on the waiting list.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Transplant Direct Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Transplant Direct Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos