دورية أكاديمية

Cost effectiveness of commercial portable ex vivo lung perfusion at a low‐volume US lung transplant center

التفاصيل البيبلوغرافية
العنوان: Cost effectiveness of commercial portable ex vivo lung perfusion at a low‐volume US lung transplant center
المؤلفون: Kent, Johnathan, Nordgren, Rachel, Ahn, Daniel, Lysandrou, Maria, Diaz, Ashley, Fenton, David, Wignakumar, Thirushan, McMeekin, Nicola, Salerno, Christopher, Donington, Jessica, Madariaga, Maria Lucia L.
المصدر: Artificial Organs ; ISSN 0160-564X 1525-1594
بيانات النشر: Wiley
سنة النشر: 2024
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Background Portable ex vivo lung perfusion during lung transplantation is a resource‐intensive technology. In light of its increasing use, we evaluated the cost‐effectiveness of ex vivo lung perfusion at a low‐volume lung transplant center in the USA. Methods Patients listed for lung transplantation (2015–2021) in the United Network for Organ Sharing database were included. Quality‐of‐life was approximated by Karnofsky Performance Status scores 1‐year post‐transplant. Total transplantation encounter and 1‐year follow‐up costs accrued by our academic center for patients listed from 2018 to 2021 were obtained. Cost‐effectiveness was calculated by evaluating the number of patients attaining various Karnofsky scores relative to cost. Results Of the 13 930 adult patients who underwent lung transplant in the United Network for Organ Sharing database, 13 477 (96.7%) used static cold storage and 453 (3.3%) used ex vivo lung perfusion, compared to 30/58 (51.7%) and 28/58 (48.3%), respectively, at our center. Compared to static cold storage, median total costs at 1 year were higher for ex vivo lung perfusion ($918 000 vs. $516 000; p = 0.007) along with the cost of living 1 year with a Karnofsky functional status of 100 after transplant ($1 290 000 vs. $841 000). In simulated scenarios, each Karnofsky‐adjusted life year gained by ex vivo lung perfusion was 1.00–1.72 times more expensive. Conclusions Portable ex vivo lung perfusion is not currently cost‐effective at a low‐volume transplant centers in the USA, being 1.53 times more expensive per Karnofsky‐adjusted life year. Improving donor lung and/or recipient biology during ex vivo lung perfusion may improve its utility for routine transplantation.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1111/aor.14816
الإتاحة: https://doi.org/10.1111/aor.14816Test
حقوق: http://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.78830419
قاعدة البيانات: BASE