Evidence map›Paper›PMID 28613436›Full record

ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2017

The Incremental Cost of Incompatible Living Donor Kidney Transplantation: A National Cohort Analysis.

D Axelrod, K L Lentine, M A Schnitzler, X Luo, H Xiao, B J Orandi, A Massie, J Garonzik-Wang, M D Stegall, S C Jordan and 24 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Kidney transplantation in highly sensitized recipients.Kidney research and clinical practice · 2021
    Article
  8. Review
  9. How do highly sensitized patients get kidney transplants in the United States? Trends over the last decade.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020
    Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors at 20 institutions in 1 country.

D AxelrodDepartment of Transplantation, Lahey Hospital and Health System, Burlington, MA.
K L LentineCenter for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO.
M A SchnitzlerCenter for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO.
X LuoDivision of Abdominal Transplantation, Department of Surgery, Johns Hopkins University, Baltimore, MD.
H XiaoCenter for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO.
B J OrandiDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA.
A MassieDivision of Abdominal Transplantation, Department of Surgery, Johns Hopkins University, Baltimore, MD.
J Garonzik-WangDivision of Abdominal Transplantation, Department of Surgery, Johns Hopkins University, Baltimore, MD.
M D StegallDepartment of Surgery, Mayo Clinic, Rochester, MN.
S C JordanDepartment of Medicine, Cedars-Sinai Comprehensive Transplant Center, Los Angeles, CA.
J OberholzerDepartment of Surgery, University of Illinois-Chicago, Chicago, IL.
T B DunnDepartment of Surgery, University of Minnesota, Minneapolis, MN.ORCID http://orcid.org/0000-0002-5941-0659
L E RatnerDepartment of Surgery, Columbia University Medical Center, New York, NY.
S KapurDepartment of Surgery, New York Presbyterian/Weill Cornell Medical Center, New York, NY.
R P PelletierDepartment of Surgery, The Ohio State University, Columbus, OH.ORCID http://orcid.org/0000-0001-6128-8333
J P RobertsDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA.
M L MelcherDepartment of Surgery, Stanford University, Palo Alto, CA.ORCID http://orcid.org/0000-0002-7185-4383
P SinghDepartment of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.ORCID http://orcid.org/0000-0002-0253-2970
D L SudanDepartment of Surgery, Duke University Medical Center, Durham, NC.
M P PosnerDepartment of Surgery, Virginia Commonwealth University, Richmond, VA.
J M El-AmmIntegris Baptist Medical Center, Transplant Division, Oklahoma City, OK.
R ShapiroDepartment of Surgery, Mt. Sinai Medical Center, New York, NY.
M CooperMedstar Georgetown Transplant Institute, Washington, DC.
G S LipkowitzDepartment of Surgery, Baystate Medical Center, Springfield, MA.
M A ReesDepartment of Urology, University of Toledo Medical Center, Toledo, OH.
C L MarshDivision of Organ Transplantation, Scripps Center for Organ Transplantation, Department of Surgery, Scripps Clinic and Green Hospital, La Jolla, CA.
B R SankariDepartment of Urology, Cleveland Clinic, Cleveland, OH.
D A GerberDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
P W NelsonDepartment of Surgery, University of Nevada, Las Vegas, NV.
J WellenDepartment of Surgery, Barnes-Jewish Hospital, St. Louis, MO.
A BozorgzadehDepartment of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA.
A Osama GaberDepartment of Surgery, Houston Methodist Hospital, Houston, TX.
R A MontgomeryDepartment of Surgery, New York University Langone Medical Center, New York, NY.
D L SegevDivision of Abdominal Transplantation, Department of Surgery, Johns Hopkins University, Baltimore, MD.
Johns Hopkins University · USSaint Louis University · USUniversity of California, San Francisco · USBarnes-Jewish Hospital · USBaystate Medical Center · USCedars-Sinai Medical Center · USCleveland Clinic · USColumbia University Irving Medical Center · USCornell University · USDuke Medical Center · USINTEGRIS Baptist Medical Center · USMayo Clinic in Arizona · USMedStar Heart & Vascular Institute · USMemorial Medical Center · USMethodist Hospital · USMount Sinai Hospital · USNYU Langone Health · USScripps Clinic · USStanford University · USThe Ohio State University · US

Funding

Quantifying Risk And Survival Benefit from Incompatible Kidney TransplantationR01DK098431 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2013 to 2017
$3.7M
Choosing Immune Suppression in Renal Transplantation by Efficacy and MorbidityR01DK102981 · NIDDK · WASHINGTON UNIVERSITY · PI DHARNIDHARKA, VIKAS R. · 2014 to 2018
$1.9M
Chronic Antibody-Mediated Injury in Renal AllograftsR01DK088791 · NIDDK · MAYO CLINIC ROCHESTER · PI STEGALL, MARK D · 2010 to 2011
$897k
Quantifying Risk and Survival Benefit from Incompatible Kidney TransplantationF32DK093218 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ORANDI, BABAK JOHN · 2011 to 2014
$185k
NIDDK NIH HHS F32 DK093218NIDDK NIH HHS R01 DK088791NIDDK NIH HHS R01 DK098431NIDDK NIH HHS R01 DK102981
6 · The paper itself

Abstract

Incompatible living donor kidney transplantation (ILDKT) has been established as an effective option for end-stage renal disease patients with willing but HLA-incompatible living donors, reducing mortality and improving quality of life. Depending on antibody titer, ILDKT can require highly resource-intensive procedures, including intravenous immunoglobulin, plasma exchange, and/or cell-depleting antibody treatment, as well as protocol biopsies and donor-specific antibody testing. This study sought to compare the cost and Medicare reimbursement, exclusive of organ acquisition payment, for ILDKT (n = 926) with varying antibody titers to matched compatible transplants (n = 2762) performed between 2002 and 2011. Data were assembled from a national cohort study of ILDKT and a unique data set linking hospital cost accounting data and Medicare claims. ILDKT was more expensive than matched compatible transplantation, ranging from 20% higher adjusted costs for positive on Luminex assay but negative flow cytometric crossmatch, 26% higher for positive flow cytometric crossmatch but negative cytotoxic crossmatch, and 39% higher for positive cytotoxic crossmatch (p < 0.0001 for all). ILDKT was associated with longer median length of stay (12.9 vs. 7.8 days), higher Medicare payments ($91 330 vs. $63 782 p < 0.0001), and greater outlier payments. In conclusion, ILDKT increases the cost of and payments for kidney transplantation.

Indexed as

Living DonorsBlood Group IncompatibilityCase-Control StudiesFemaleFollow-Up StudiesGlomerular Filtration RateGraft RejectionGraft SurvivalHistocompatibility TestingHumansKidney Failure, ChronicKidney Function TestsKidney TransplantationMaleMiddle AgedPostoperative Complicationsclinical research/practicedesensitizationeconomicshealth services and outcomes researchkidney transplantation: living donorkidney transplantation/nephrology

Identifiers

PMID28613436
PMCPMC12404663
OpenAlexW2737354682

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.