Document Detail


Cost analysis of kidney transplantation in highly sensitized recipients compared to intermittent maintenance hemodialysis.
MedLine Citation:
PMID:  23274328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Kidney transplantation in allosensitized recipients has recently increased. Studies performing cost analysis of desensitization protocols are scarce.
MATERIAL/METHODS: We performed an actual cost comparison between kidney transplantation following desensitization and maintenance hemodialysis. Group A (n=35) consisted of allosensitized recipients who underwent desensitization using immunoadsorption and/or plasmapheresis, intravenous immunoglobulin and anti-CD20 antibody who were followed for ≥ 2 years. Group B (n=49) consisted of matched patients who remained on hemodialysis throughout the study period. Actual costs of donor care, surgical procedures, out-patient visits, in-hospital admissions, medications, hemodialysis, immunoadsorption, plasmapheresis, and laboratory and radiology investigations were calculated. Health care services were provided by a single institution.
RESULTS: Mortality rate was similar between both groups. The average 4-year actual total cost was $210,779 in group A and $317,186.3 in group B; respectively (p=0.017). Average total cost per patient in group A was $186,608; $14,233; $5,536; $4,402 in the first, second, third and fourth years after transplantation respectively while the average total annual cost per patient in group B was $79,296. The total cost in both groups became equal by month 31. The predicted annual cost savings in group A after 31 months was $33,943.
CONCLUSIONS: Despite using costly desensitization protocols, kidney transplantation in sensitized patients provides long-term cost savings compared to maintenance hemodialysis.
Authors:
Ahmed Al-Jedai; Mohammed Alsultan; Khalid Almeshari; Khalid Alshaibani; Hazem Elgamal; Delal Alkortas; Fowad Khurshid; Mai Altalhi; Khaled Hamawi
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  17     ISSN:  2329-0358     ISO Abbreviation:  Ann. Transplant.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-05-28     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  82-91     Citation Subset:  IM    
Affiliation:
Division of Pharmacy Services, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal, Murine-Derived / economics,  therapeutic use
Female
Follow-Up Studies
Graft Enhancement, Immunologic / economics*,  methods
Graft Rejection / prevention & control
HLA Antigens / immunology
Histocompatibility
Hospital Costs / statistics & numerical data*
Humans
Immunoglobulins, Intravenous / economics,  therapeutic use
Immunologic Factors / economics,  therapeutic use
Immunosuppressive Agents / economics,  therapeutic use
Isoantibodies
Kidney Failure, Chronic / economics,  mortality,  therapy*
Kidney Transplantation / economics*,  immunology,  mortality
Male
Middle Aged
Renal Dialysis / economics*,  methods,  mortality
Retrospective Studies
Saudi Arabia
Sorption Detoxification / economics,  methods
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/HLA Antigens; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/Isoantibodies; 0/rituximab

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