Effects of expanded allocation programmes and organ and recipient quality metrics on transplant-related costs in kidney transplantation - an institutional analysis.
Transpl Int
; 32(10): 1074-1084, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31099091
ABSTRACT
Expansions of donor pools have a controversial impact on healthcare expenditures. The aim of this study was to investigate the emerging costs of expanded criteria donor (ECD) kidney transplantations (KT) and to identify independent risk factors for increased transplant-related costs. We present a retrospective explorative analysis of hospital costs and reimbursements of KTs performed between 2012 and 2016 in a German university hospital. A total of 174 KTs were examined, including 92 (52.9%) ECD organ transplantations. The ECD group comprised 43 (24.7%) 'old-for-old' transplantations. Median healthcare costs were 19 570 (IQR 18 735-27 405) in the standard criteria donor (SCD) group versus 25 478 (IQR 19 957-29 634) in the ECD group (+30%; P = 0.076). 'Old-for-old' transplantations showed the highest healthcare expenditures [26 702 (19 570-33 940)]. Irrespective of the allocation group, transplant-related costs increased significantly in obese (+6221; P = 0.009) and elderly recipients (+6717; P = 0.019), in warm ischaemia time exceeding 30 min (+3212; P = 0.009) and in kidneys with DGF or surgical complications (+8976 and +10 624; both P < 0.001). Transplantation of ECD organs is associated with incremental costs, especially in elderly and obese recipients. A critical patient selection, treatment of obesity before KT and keeping warm ischaemia times short seem to be crucial, in order to achieve a cost-effective KT regardless of the allocation group.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obtenção de Tecidos e Órgãos
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Transplante de Rim
Tipo de estudo:
Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Transpl Int
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha