Comparative study on two kidney graft rinsing and preservation solutions in terms of the post-transplantation risk of delayed graft function and cost.
OBJECTIVE
To determine whether Belzer solution (Viaspan, Bristol-Myers Squibb, Brussels, Belgium), which is more expensive than Eurocollins solution, was better at preventing delayed graft function (DGF) and whether it was cost-effective as it could potentially reduce post-transplantation complications.


METHODS
The risk of occurrence of complications associated with the use of these two rinsing and preserving solutions was estimated from a survey of 106 patients undergoing renal transplantation between 1 January 1993 and 31 March 1998. Both efficacy and adverse outcomes were recorded along with the costs directly associated with the transplantation procedure in the hospital setting: hospitalization, rinsing and preserving solutions, medical and technical interventions and diagnostic tests.


RESULTS
For the 45 kidney grafts rinsed and preserved with Eurocollins (strategy S1: n1 = 45) the cost/graft was estimated at 40 euros. With Viaspan (strategy S2: n2 = 61) the corresponding cost/graft was 424 euros. Logistic regression analysis showed that Viaspan was better than Eurocollins solution (ebeta = 0.437; P = 0.05) in preventing DGF. Overall, S2 was less expensive than S1, from the hospital's perspective. The mean difference per patient was 278 euros, which amounts to a saving of 2% of the total cost per renal transplantation. For rinsing and preserving kidney grafts Belzer solution is therefore preferable to Eurocollins solution.
Vincentelli
J
J
Department of Pharmacy, Department of Renal Transplantation, CHU-Sud, Public Health Service, Université de la Méditerranée, Marseille, France. jerome.vincentelli@ap-hm.fr
Luccioni
A
A
Devictor
B
B
Dussol
B
B
Lechevallier
E
E
Bertault-Peres
P
P
Coulange
C
C
Berland
Y
Y
Penot Ragon
C
C
D000241:Adenosine / Q000009:adverse effects / Q000191:economics*; D000493:Allopurinol / Q000009:adverse effects / Q000191:economics*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005978:Glutathione / Q000009:adverse effects / Q000191:economics*; D006085:Graft Survival; D006801:Humans; D006982:Hypertonic Solutions / Q000009:adverse effects / Q000191:economics*; D007328:Insulin / Q000009:adverse effects / Q000191:economics*; D007668:Kidney; D016030:Kidney Transplantation / Q000009:adverse effects / Q000191:economics*; D007683:Kidney Tubular Necrosis, Acute / Q000209:etiology / Q000517:prevention & control; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions / Q000009:adverse effects / Q000191:economics*; D011887:Raffinose / Q000009:adverse effects / Q000191:economics*; D012189:Retrospective Studies
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose