The shrinking renal replacement therapy "break-even" point.
Annual Meeting of the American Society of Transplant Physicians. Chicago, IL, USA, 1998/05/09.
This study examines the current cost of live donor (LD) transplantation at our institution, and compares it with that of dialysis.
The study population consisted of 184 consecutive adult recipients of laparoscopically procured LD kidney transplants.
Cost-containment measures instituted during this series included elimination of routine postoperative antilymphocyte induction and an accelerated discharge clinical pathway with planned discharge of the recipient on postoperative day (POD) 2. Costs of the transplants to Medicare were estimated from hospital charges, readmission rates, and immunosuppressant usage.
These were compared with published costs of dialysis to Medicare in terms of a fiscal transplant-dialysis break-even point.
Kaplan-Meier patient and graft survival rates at 1 year were 97 and 93%, respectively.
Among patients followed for at least 90 days and treated with no induction and either cyclosporine-mycophenolate mofetil or tacrolimus-mycophenolate mofetil, acute rejection rates were low (27.6 and 13.9%, respectively).
In the last 124 patients, 32.3% were discharged by POD 3 and 71.8% by POD 6, with corresponding mean transplant hospital charges (excluding organ acquisition) of $11,873 and $17,350, respectively.
The 30-day readmission rate for patients discharged on the accelerated pathway by POD 3 was only 16%. (...)
Mots-clés Pascal : Homotransplantation, Rein, Donneur apparenté, Dialyse, Coût, Réduction, Etude comparative, Pronostic, Sortie hôpital, Précoce, Traitement, Chimiothérapie, Immunodépresseur, Homme, Transplantation, Chirurgie, Economie santé, Epuration extrarénale, Donneur vivant
Mots-clés Pascal anglais : Homotransplantation, Kidney, Related donor, Dialysis, Costs, Reduction, Comparative study, Prognosis, Hospital discharge, Early, Treatment, Chemotherapy, Immunosuppressive agent, Human, Transplantation, Surgery, Health economy, Extrarenal dialysis, Living donor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0127546
Code Inist : 002B25H. Création : 16/11/1999.