Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation

David A. Axelrod, Darren Malinoski, Madhukar S. Patel, Kristine Broglio, Roger Lewis, Tahnee Groat, Krista L. Lentine, Mark Schnitzler, Claus U. Niemann

    Research output: Contribution to journalArticle

    Abstract

    Delayed graft function (DGF) in kidney transplant significantly increases inpatient and outpatient cost. Targeted, mild hypothermia in organ donors after neurologic determination of death significantly reduced the rate of DGF in a recent randomized controlled clinical trial. To assess the potential economic benefit of national implementation of donor hypothermia, rates of reduction DGF were combined with estimates of the impact of DGF on hospital cost and total health expenditure for standard and extended criteria donor organs (SCD and ECD). DGF increases the cost of the transplant episode by $9487 for ECD transplant and $10 342 for SCD transplant. Medicare recipients with DGF incur an additional $18 513 spending for ECD and $14 948 in SCD transplants over the first year. An absolute reduction in DGF rate after kidney transplantation consistent with trial results (ECD 25%, SCD 7%) has the potential to lower annual hospital cost for kidney transplant by $13 178 746 and annual Medicare spending by $20 970 706 compared to standard donor management practice using static cold storage. Targeted mild hypothermia improves care of renal transplant patients by safely reducing DGF rates in both ECD and SCD transplant. Broader application of this safe, effective, and low-cost intervention could reduce healthcare expenditures for providers and insurers.

    Original languageEnglish (US)
    Article numbere13626
    JournalClinical Transplantation
    Volume33
    Issue number7
    DOIs
    StatePublished - Jul 1 2019

    Fingerprint

    Delayed Graft Function
    Hypothermia
    Kidney Transplantation
    Economics
    Tissue Donors
    Transplants
    Hospital Costs
    Health Expenditures
    Medicare
    Kidney
    Costs and Cost Analysis
    Insurance Carriers
    Practice Management
    Health Personnel
    Nervous System
    Inpatients
    Outpatients
    Randomized Controlled Trials

    Keywords

    • cost
    • deceased organ donors
    • donor management
    • hypothermia

    ASJC Scopus subject areas

    • Transplantation

    Cite this

    Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation. / Axelrod, David A.; Malinoski, Darren; Patel, Madhukar S.; Broglio, Kristine; Lewis, Roger; Groat, Tahnee; Lentine, Krista L.; Schnitzler, Mark; Niemann, Claus U.

    In: Clinical Transplantation, Vol. 33, No. 7, e13626, 01.07.2019.

    Research output: Contribution to journalArticle

    Axelrod, DA, Malinoski, D, Patel, MS, Broglio, K, Lewis, R, Groat, T, Lentine, KL, Schnitzler, M & Niemann, CU 2019, 'Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation', Clinical Transplantation, vol. 33, no. 7, e13626. https://doi.org/10.1111/ctr.13626
    Axelrod, David A. ; Malinoski, Darren ; Patel, Madhukar S. ; Broglio, Kristine ; Lewis, Roger ; Groat, Tahnee ; Lentine, Krista L. ; Schnitzler, Mark ; Niemann, Claus U. / Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation. In: Clinical Transplantation. 2019 ; Vol. 33, No. 7.
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