Evidence map›Paper›PMID 38988688›Full record

ArticleTransplantation direct2024

Use of Machine Perfusion to Increase the Number of Expanded Criteria Deceased Donor Kidney Transplants: A Pharmacoeconomic Analysis.

Helio Tedesco Silva, Teresa Raquel de Moraes Ramos, Deise De Boni Monteiro de Carvalho, Gustavo Fernandes Ferreira, João Marcelo Medeiros de Andrade, Luis Gustavo Modelli de Andrade, Mario Abbud-Filho, Renato Demarchi Foresto, Roberto Ceratti Manfro, Ronaldo de Matos Esmeraldo and 4 more

Abstract read
In one paragraph

Article in Transplantation direct, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Optimizing the Use of Deceased Donor Kidneys at Risk of Discard: A Clinical Practice Guideline.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Guideline
  2. Article
  3. Observational
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Helio Tedesco SilvaHospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.
Teresa Raquel de Moraes RamosWomen's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-6137-3658
Deise De Boni Monteiro de CarvalhoHospital São Francisco na Providência de Deus, Rio de Janeiro, Brazil.
Gustavo Fernandes FerreiraTransplant Unit Santa Casa Juiz de Fora, Juiz de Fora, Brazil.ORCID https://orcid.org/0000-0002-0036-0298
João Marcelo Medeiros de AndradeUnidade de Transplantes-Instituto de Medicina Integral Prof. Fernando Filgueira, Recife, Brazil.ORCID https://orcid.org/0000-0003-0228-7538
Luis Gustavo Modelli de AndradeUniversidade Estadual Paulista, Botucatu, Brazil.ORCID https://orcid.org/0000-0002-0230-0766
Mario Abbud-FilhoHospital de Base, Medical School FAMERP, São José do Rio Preto, Brazil.ORCID https://orcid.org/0000-0002-5079-9813
Renato Demarchi ForestoHospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-9370-0265
Roberto Ceratti ManfroHospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.ORCID https://orcid.org/0000-0001-8324-3734
Ronaldo de Matos EsmeraldoHospital Geral de Fortaleza, Fortaleza, Brazil.ORCID https://orcid.org/0000-0001-6327-9991
Tainá Veras de Sandes FreitasHospital Geral de Fortaleza, Fortaleza, Brazil.ORCID https://orcid.org/0000-0002-4435-0614
Valter Duro GarciaSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.ORCID https://orcid.org/0000-0002-7394-1501
José Medina PestanaHospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-0750-7360
Marcelo Cunio Machado FonsecaWomen's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-0803-3715

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The discard of expanded criteria donor (ECD) kidneys is unacceptably high, considering the growing demand for transplantation. Using machine perfusion may reduce the discard rate, increase the number of transplants, and reduce mortality on the waiting list. Methods: We developed a 5-y Markov model to simulate incorporating the pulsatile perfusion machine into the current government-funded healthcare system. The model compared the universal use of static cold storage for all kidneys with the selective use of machine perfusion for ECD kidneys. Real-life data were used to compose the cohort characteristics in this model. This pharmacoeconomic analysis aimed to determine the cost-effectiveness and budgetary impact of using machine perfusion to preserve ECD kidneys. Results: Compared with the universal use of static cold storage, the use of machine perfusion for ECD kidneys was associated with an increase in the number of kidney transplants (n = 1123), a decrease in the number of patients on the waiting list (n = 815), and decrease in mortality (n = 120), with a cost difference of US dollar 4 486  009 in the period. The budget impact analysis revealed an additional cost of US dollar 4 453 749 >5 y. The budget impact analysis demonstrated a progressive reduction in costs, becoming cost-saving during the last year of the analysis. Conclusions: This stochastic model showed that incorporating machine perfusion for ECD kidneys is most often a dominant or cost-effective technology associated with an increase in the number of transplants and a reduction in the number of patients on the waiting list, reducing mortality on the waiting list.

Identifiers

PMID38988688
PMCPMC11230806

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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.