High cold ischemia time (CIT) and inadequate care of donors in Brazil lead to a high incidence of delayed graft function (DGF), 60%-70%, and as a consequence: an increase in hospitalization and poor long-term graft survival. Objective: Analyze the cost-effectiveness of renal machine perfusion (MP) after long CIT in comparison to cold static storage (CS). Methods: 54 kidney transplantations from deceased donors, which were preserved with MP after long CIT in static storage, were compared to 101 historic control group which were preserved in CS. The impact of these 2 methods of preservation on incidence and duration of DGF, length of hospital stay (LOS) and graft survival at 1 year was analysed. A probabilistic decision tree was designed that considered the DGF as the outcome and included data from our hospital. We measured incremental cost-effectiveness ratio (ICER) and applied a sensitivity analysis. The following costs were considered: surgery, in-hospital day, dialysis, hemotherapy, exams, disposables (machine kit), preservation solution and depreciation. Dollar exchange rate used was R$3.90/dollar from Nov/15. Results: MP added 11 hours of CIT to CS. The MP group reduced incidence of DGF (79% versus 61%;p=0.02),time of DGF (11 versus 5 days;p < 0.001), and LOS(18 versus 13 days p<0.001). There was no difference on graft survival between groups. Mean costs were US$14,140.12 in the MP group and US$16,550.32 for the CS. The ICER was negative, each DGF avoid saved -US$13,390.00. Costs were mainly influenced by LOS and duration of DGF.Conclusions: The use of a MP after long CIT contributed to faster recovery of renal function, shorter LOS and better cost-effectiveness in a short-term.

CITATION INFORMATION: Matos A, Malheiro D, Morgado S, Requi[acirc]o-Moura L, Souza-Durão M, Tonato E, Nogueira M, Borrelli M, Pacheco-Silva A. Cost-Effectiveness of Renal Machine Perfusion Use After Long Cold Ischemia Time. Am J Transplant. 2017;17 (suppl 3).

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