@article{19e2a767f9814317ac72a24473de1c96,
title = "Modeling the economic benefit of targeted mild hypothermia in deceased donor kidney transplantation",
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.",
keywords = "cost, deceased organ donors, donor management, hypothermia",
author = "Axelrod, {David A.} and Darren Malinoski and Patel, {Madhukar S.} and Kristine Broglio and Roger Lewis and Tahnee Groat and Lentine, {Krista L.} and Mark Schnitzler and Niemann, {Claus U.}",
note = "Funding Information: This publication was supported by Grant No. R38OT22183 (to Claus U. Niemann, MD) from the Health Resources and Services Administration (HRSA), US Department of Health and Human Services. The contents of this publication are solely the responsibility of the author(s) and do not necessarily represent the views of HRSA. Funding Information: We would like to thank all staff members from California Transplant Donor Network (now Donor Network West), OneLegacy, and all participating hospitals for their tireless efforts as well as the donors, recipients, and their families. This work was conducted under the auspices of the Minneapolis Medical Research Foundation (MMRF), contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201000018C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2019",
month = jul,
doi = "10.1111/ctr.13626",
language = "English (US)",
volume = "33",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "7",
}