The Cost-Effectiveness of Organ Preservation Methods in Renal Transplantation: US Projections Based on the Machine Preservation Trial
Abstract
Introduction
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).
Conclusion
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.
aBridgehead International, Wayland, Massachusetts, USA
bTransplantProfessionals.com, LLC, Rochester, Minnesota, USA
Address reprint requests to Roger W. Evans, PhD, TransplantProfessionals.com, LLC, 2251 Baihly Hills Drive Southwest, Rochester, MN 55902-1311
The authors are paid consultants to Organ Recovery Systems, Inc, 2570 E Devon Avenue, Des Plaines, IL 60018 USA. Organ Recovery Systems, Inc. has funded the research reported here.
ABSTRACT