Cost-Effectiveness of Kidney Transplantation From DCD in Italy

Cavallo, Maria Caterina; Sepe, Vincenzo; Conte, Ferruccio; Abelli, Massimo; Ticozzelli, Elena; Bottazzi, Andrea; Geraci, P

doi:10.1016/j.transproceed.2014.09.146

Cited by 36 publications

(28 citation statements)

References 31 publications

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“…Because of differences in healthcare reimbursement settings, the medical resources considered and study designs, a comparison between the present study and the ones reported above would not be suitable even if the majority of those studies had found that KTx offered cost savings vs dialysis. With regard to Italy, only one published study, which was based on a Markov model, aimed to evaluate the healthcare costs and clinical outcomes of different types of kidney transplantation vs current clinical practice (ie, dialysis), and it found that this intervention can be considered cost effective . The present study has some limits, which are mainly linked to the structure of the administrative databases, which, as previously discussed, do not collect clinical data or indirect costs and do not allow for distinguishing costs related to the specific disease or its comorbidities .…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, from the economic point of view, dialysis treatment is particularly expensive for health systems even in the most developed countries and difficult to sustain for the majority of emerging ones . Renal transplantation is widely recognized as the therapy of choice for an important portion of patients with ESRD, providing a better quality of life, longer expected survival, and more cost savings in the medium‐term period than maintenance dialysis . Even if several clinical studies demonstrated that the possibility of a successful outcome is higher if the transplantation is made before long‐term dialysis, only approximately 2.5% of patients with ESRD undergo this intervention as the first RRT procedure .…”

Section: Introductionmentioning

confidence: 99%

“…In 2017, 1927 kidney transplants (including multiorgan transplants) were performed in Italy, representing an increase of 7.3% compared to 2016, due to a greater number of transplants from living donors (5%) and from deceased donors (10%), but this increase only slightly reduced the waiting list (6492 still pending in December 2017) . Very limited evidence is actually available regarding the direct healthcare costs associated with renal transplantations at the international and, especially, at the Italian level . The present study analyzes the information collected in the administrative database of the largest Italian region (Lombardy, which has approximately 9.7 million inhabitants, representing 16% of the entire Italian population of approximately 59 million people) for all patients receiving a kidney transplant (KTx) in the year 2011.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Real‐world data on healthcare resource consumption and costs before and after kidney transplantation

Roggeri¹,

Roggeri²,

Zocchetti³

et al. 2019

Clinical Transplantation

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End-stage renal disease (ESRD) is increasing worldwide as a consequence of population aging and increasing chronic illness. Treatment consists mostly of dialysis and kidney transplantation (KTx), and KTx offers advantages for life expectancy and longterm cost reductions compared with dialysis. This study uses the administrative database of the Lombardy Region to analyze the costs of a cohort of patients with ESRD receiving KTx, covering a time period of 24 months before transplant to 12 months after. During 2011, 276 patients underwent kidney transplantation (8.7% preemptive and 91.3% non-preemptive). In the period before transplantation, the main cost driver was dialysis (66.6% for the period from −24 to −12 months and 73.8% for the period from −12 to 0 months), while in the 12 months after KTx, the most relevant cost was surgery. The total cost −24 to −12 months pre-KTx was 35 049.2€; the cost −12 to 0 months was 36 745.9€; and the cost 12 months after KTx was 43 805.8€. Nonpreemptive patients showed much higher costs both pre-and post-KTx than preemptive patients. This study highlights how KTx modifies the resource consumption and costs composition of patients with ESRD vs those undergoing dialysis treatment and how KTx may be economically beneficial, especially preemptive intervention.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Real‐world data on healthcare resource consumption and costs before and after kidney transplantation

Roggeri¹,

Roggeri²,

Zocchetti³

et al. 2019

Clinical Transplantation

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“…Specifically, authors assessed the incremental health care costs and benefits of the following: 1) an increase in the number of new ESRD patients receiving atransplant from donation after cardiac death (DCD); and 2) an increase in the total number of transplants (all types) supplied to new ESRD patients, compared with current clinical practice for treating patients with ESRD in the same setting [13]. The study was based on a dynamic population-based Markov, estimating the costs and benefits of proposed changes in service delivery to ESRD patients.…”

Section: Comparative Cost-effectiveness Of Esrd Treatment Optionsmentioning

confidence: 99%

“…Overall, the study concludes that changing the actual practice pattern for new patients with ESRD by increasing the availability of kidneys from DCD should result in a cost-effective policy to expand the kidney donor pool. Thus, the authors argue that their results should encourage a health policy expressively tailored to reach markedly higher rates of kidney transplants by using extended criteria to select donors such as those experiencing cardiac death [13].…”

Section: Comparative Cost-effectiveness Of Esrd Treatment Optionsmentioning

confidence: 99%

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

Tataradze¹,

Managadze²,

Beglarashvili³

et al. 2016

IJCM

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End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems mainly due to substantial treatment-associated costs. The chronic nature of the disease needs expensive continuous care that majority of the patients cannot afford. Therefore, in many countries expenses associated with the ESRD treatment is paid by state government. These treatment options include: hemodialysis, peritoneal dialysis and kidney transplantation. Multiple studies have been conducted throughout the world to assess cost-effectiveness of these treatment modalities. The studies suggest that kidney transplantation not only reduces mortality and morbidity but improves a quality of life of ESRD patients. Furthermore, it is the most cost-effective treatment for the ESRD at least in high-income countries. The goal of our study was to determine whether above-mentioned is true for lower middle income countries, where the cost of the ESRD treatment is substantially lower. Despite the low dialysis costs, transplantation remains the cheapest form of renal replacement therapy RRT in lower income countries like Georgia. Our results reveal, that kidney transplantation is most expensive modality of Renal Replacement Therapy (RRT) at month 1, but count of costs reveals that after the 10 th month of treatment, the cumulative cost of transplantation is less than the cumulative cost of peritoneal dialysis and after the 23 rd month, cumulative cost of hemodialysis also surpasses the cumulative cost of transplantationrelated treatment and this cost comparison is in line with global data from upper-middle and high income countries. A. Tataradze et al. 438

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The Use of Diffusion Tensor Imaging in the Identification of Acute Rejection and Chronic Allograft Nephropathy After Renal Transplantation

Jiang,

Yu,

Wan

et al. 2023

Magnetic Resonance Imaging

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BackgroundIdentifying the cause of renal allograft dysfunction is important for the clinical management of kidney transplant recipients.PurposeTo evaluate the diagnostic efficiency of diffusion tensor imaging (DTI) for identifying allografts with acute rejection (AR) and chronic allograft nephropathy (CAN).Study TypeProspective.SubjectsSeventy‐seven renal transplant patients (aged 42.5 ± 9.5 years), including 29 patients with well‐functioning stable allografts (Control group), 25 patients diagnosed with acute rejection (AR group), and 23 patients diagnosed with chronic allograft nephropathy (CAN group).Field Strength/Sequence1.5 T/T2‐weighted imaging and DTI.AssessmentThe serum creatinine, proteinuria, pathologic results, and fractional anisotropy (FA) values were obtained and compared among the three groups.Statistical TestOne‐way analysis of variance; correlation analysis; independent‐sample t‐test; intraclass correlation coefficients and receiver operating characteristic curves. Statistical significance was set to a P‐value <0.05.ResultsThe AR and CAN groups presented with significantly elevated serum creatinine as compared with the Control group (191.8 ± 181.0 and 163.1 ± 115.8 μmol/L vs. 82.3 ± 20.9 μmol/L). FA decreased in AR group (cortical/medullary: 0.13 ± 0.02/0.31 ± 0.07) and CAN group (cortical/medullary: 0.11 ± 0.02/0.27 ± 0.06), compared with the Control group (cortical/medullary: 0.15 ± 0.02/0.35 ± 0.05). Cortical FA in the AR group was higher than in the CAN group. The area under the curve (AUC) for identifying AR from normal allografts was 0.756 and 0.744 by cortical FA and medullary FA, respectively. The AUC of cortical FA and medullary FA for differentiating CAN from normal allografts was 0.907 and 0.830, respectively. The AUC of cortical FA and medullary FA for distinguishing AR and CAN from normal allografts was 0.828 and 0.785, respectively. Cortical FA was able to distinguish between AR and CAN with an AUC of 0.728.Data ConclusionDTI was able to detect patients with dysfunctional allografts. Cortical FA can further distinguish between AR and CAN.Evidence Level2Technical EfficacyStage 2

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Cost-Effectiveness of Kidney Transplantation From DCD in Italy

Cited by 36 publications

References 31 publications

Real‐world data on healthcare resource consumption and costs before and after kidney transplantation

Real‐world data on healthcare resource consumption and costs before and after kidney transplantation

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

The Use of Diffusion Tensor Imaging in the Identification of Acute Rejection and Chronic Allograft Nephropathy After Renal Transplantation

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