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A Cost Benefit Analysis of Different Minimal Access Donor Nephrectomy Techniques Performed at a Busy Transplant Centre

H. Sharma1, A. Odougoudar2, A. Sharma2, D. Ridgway2, A. Hammad2, S. Mehra2

1Transplant and Vascular Access Surgery, Royal Liverpool University Hospital, Liverpool, United Kingdom, 2Transplant and Vascular Access Surgery, Royal Liverpool Hospital, Liverpool, United Kingdom

Meeting: 2021 American Transplant Congress

Abstract number: 383

Keywords: N/A

Topic: Clinical Science » Ethics » Non-Organ Specific: Economics & Ethics

Session Information

Session Name: A Penny for Your Thoughts: the Economics and Psychosocial Aspects of Transplant

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 8, 2021

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:05pm-6:10pm

Location: Virtual

*Purpose: We performed the cost-benefit analyses comparing Total Laparoscopic Retroperitoneoscopic donor nephrectomy (TLTLRPDN) versus Hand-assisted laparoscopic donor nephrectomy (HALDN) operations performed at our centre since 2011. Recently published cost figures of Robotic assisted donor nephrectomy (RADN) were used to compare our results.

*Methods: We used a micro-costing approach to estimate the cost from the hospital perspective for N= 173 minimal access donor nephrectomies ( N= 137 – TLRPDN; 35 – HALDN). Cost estimates took into account, sterilization costs for multiple-use equipment, costs for purchasing single-use equipment, staff, hospital stay and intraoperative medications and post-op analgesia. Quality-Adjusted Life Year (QALY) was assessed at 1-year post-operatively and then annually.

*Results: The donor characteristics were similar in both groups: Median age 52.7 ( 26-78) years – TLRPDN/ 54 ( 25-74) years – HALDN, Median BMI 26.5±4 TLRPDN versus 27.2±5 HALDN, Mean PCA time 1.6 days TLRPDN versus 2.4 days HALDN, Mean Hospital stay 3.5 ± 1.2 days TLRPDN versus 4.1± 1.6 days. (p=NS) The average costs for a single non complicated TLRPDN was (total $12,203)- Theatre ( Instruments, & Staff) $6,444; Ward-Stay $4968 and Other Costs (tests, drugs & PCA) $791. The average costs for a single non complicated HALDN was ( total $13,390)- Theatre (Instruments & Staff) $7,251; Ward-Stay $4,967 and Other Costs (tests, drugs and PCA) $1,172. In comparison, the published data quotes average RADN theatre alone costs at $8913 . The average Quality Adjusted Life Year (QALY) at 1 and 3 years were 0.84/2.54 for TLRPDN and 0.79/ 2.32 for HALDN. The QALY gained with TLRPDN was 0.22, with cost per QALY gained at 3 years was $2,551.

*Conclusions: TLRPDN provides cost-benefit compared to HALDN . More costing data needs to be published with regards to RADN.

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To cite this abstract in AMA style:

Sharma H, Odougoudar A, Sharma A, Ridgway D, Hammad A, Mehra S. A Cost Benefit Analysis of Different Minimal Access Donor Nephrectomy Techniques Performed at a Busy Transplant Centre [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/a-cost-benefit-analysis-of-different-minimal-access-donor-nephrectomy-techniques-performed-at-a-busy-transplant-centre/. Accessed May 28, 2025.

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