The cost-effectiveness of organ preservation methods in renal transplantation: US projections based on the machine preservation trial.
BACKGROUND
The European Machine Preservation Trial (MPT) found a significantly lower rate of delayed graft function and improved graft survival in machine-perfused kidneys compared to cold-stored kidneys in the first year following kidney transplantation. Little is known about the cost-effectiveness of various organ preservation methods.


METHODS
Outcome data from the MPT have been used to conduct a comparative cost-effectiveness analysis based on preservation method for both standard criteria (SCD) and expanded criteria donor (ECD) kidney transplants in the United States. Using graft survival as the primary outcome measure, a cost-effectiveness model was developed using Medicare and private payer cost/payment data, as well as clinical transition probabilities based on the MPT and other studies.


RESULTS
At 1-year posttransplant, machine perfusion is a more cost-effective option than cold storage for organ preservation in transplants involving either SCD ($92,561 vs $104,118) or ECD ($106,012 vs $114,530) kidneys. Moreover, the cost-effectiveness ratios for transplants involving machine-perfused ECD kidneys ($106,012) are similar to those for transplants using cold-stored SCD kidneys ($104,118).


CONCLUSIONS
Machine perfusion is preferable to cold storage for organ preservation in both SCD and ECD donor kidney transplants. Not only is it more cost-effective, but from all relevant perspectives it adds substantial value.
Garfield
S S
SS
Bridgehead International, Wayland, Massachusetts, USA.
Poret
A W
AW
Evans
R W
RW
D003362:Cost-Benefit Analysis; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics*; D009926:Organ Preservation / Q000191:economics* / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000191:economics; D011336:Probability; D017582:Renal Replacement Therapy / Q000191:economics; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States