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The economic impact of machine perfusion technology in liver transplantation.
Boteon, Yuri L; Hessheimer, Amelia J; Brüggenwirth, Isabel M A; Boteon, Amanda P C S; Padilla, María; de Meijer, Vincent E; Domínguez-Gil, Beatriz; Porte, Robert J; Perera, M Thamara P R; Martins, Paulo N.
Afiliación
  • Boteon YL; Liver Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Hessheimer AJ; Hepatopancreatobiliary Surgery & Transplantation, General & Digestive Surgery Service, Hospital Universitario La Paz, Madrid, Spain.
  • Brüggenwirth IMA; Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Boteon APCS; Liver Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Padilla M; Organización Nacional de Trasplantes, Ministerio de Sanidad, Madrid, Spain.
  • de Meijer VE; Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Domínguez-Gil B; Organización Nacional de Trasplantes, Ministerio de Sanidad, Madrid, Spain.
  • Porte RJ; Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Perera MTPR; Liver Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Martins PN; Department of Surgery, Transplant Division, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Artif Organs ; 46(2): 191-200, 2022 Feb.
Article en En | MEDLINE | ID: mdl-34878658
INTRODUCTION: Several clinical studies have demonstrated the safety, feasibility, and efficacy of machine perfusion in liver transplantation, although its economic outcomes are still underexplored. This review aimed to examine the costs related to machine perfusion and its associated outcomes. METHODS: Expert opinion of several groups representing different machine perfusion modalities. Critical analysis of the published literature reporting the economic outcomes of the most used techniques of machine perfusion in liver transplantation (normothermic and hypothermic ex situ machine perfusion and in situ normothermic regional perfusion). RESULTS: Machine perfusion costs include disposable components of the perfusion device, perfusate components, personnel and facility fees, and depreciation of the perfusion device or device lease fee. The limited current literature suggests that although this upfront cost varies between perfusion modalities, its use is highly likely to be cost-effective. Optimization of the donor liver utilization rate, local conditions of transplant programs (long waiting list times and higher MELD scores), a decreased rate of complications, changes in logistics, and length of hospital stay are potential cost savings points that must highlight the expected benefits of this intervention. An additional unaccounted factor is that machine perfusion optimizing donor organ utilization allows patients to be transplanted earlier, avoiding clinical deterioration while on the waiting list and the costs associated with hospital admissions and other required procedures. CONCLUSION: So far, the clinical benefits have guided machine perfusion implementation in liver transplantation. Albeit there is data suggesting the economic benefit of the technique, further investigation of its costs to healthcare systems and society and associated outcomes is needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Perfusión / Trasplante de Hígado Tipo de estudio: Health_economic_evaluation Límite: Humans Idioma: En Revista: Artif Organs Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Perfusión / Trasplante de Hígado Tipo de estudio: Health_economic_evaluation Límite: Humans Idioma: En Revista: Artif Organs Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos