In Brazil the incidence of DGF is very high (60-70%) mainly due to an inadequate care of the donors and long cold ischemia time. This high incidence of DGF is associated to a longer hospitalization and poorer long term graft survival. Data from 54 kidneys from DD preserved in the MP after a long cold ischemic time (mean 22 hours of CIT) transplanted from 2/2013 to 07/2014 to 101 kidney transplants preserved by Cold storage (Control Group), realized from 11/2008 to 5/2012 at our hospital, showed the following results despite adding 10 hours of CIT in MP group: DGF incidence was 61,1% for MP compared to 79,2% in the control group (p= 0,02), the median DGF duration was 1 day in the MP compared to 9 days in the control group (p<0,001) and the hospital discharge was 13 days for the MP and 18 days for the control group (p<0,011). Considering this data, the objective of this work is to analyze the relative cost-effectiveness of two different storage methods: MP after long CIT versus CS. Methods: A probabilistic decision tree was developed to compare MP versus CS. The structure of the model was populated by review of the literature an outcomes of KT in our center. The model estimated the incremental cost-effectiveness ratio (ICR) in terms of DGF. The following costs were analysed and compared between groups: transplant surgery; hospitalization stay; dialysis post-transplant; hemotherapy; laboratory and image tests; costs of preservation solution and kits; depreciation of devices. We considered values from september 2014. Results: Resource consumption for CS according to graft function was: $17,668.39 for immediate graft function (IGF) recipients and $28,902.05 for DGF recipientes. In MP group was $16,939.86 for IGF and $22,046.07 for DGF recipients. The incremental cost-effectiveness ratio was $360.42 for each 1% of DGF saved. Conclusions: The use of the MP after long cold ischemic time in a kidney transplant program

decreases DGF, contributed to a faster recovery of renal function and to a shorter time of hospitalization and

is cost-effective in terms of savings for DGF.

CITATION INFORMATION: Matos A, Malheiros D, Morgado S, Requiao-Moura L, Borrelli M, Nogueira M, Durao M, Tonato E, Pacheco-Silva A. Cost-Effectiveness of Machine Perfusion Use After Long Cold Ischemic Time in a Kidney Transplantation Program. Am J Transplant. 2016;16 (suppl 3).

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