Background: Live kidney donation has a clear economical benefit over cadaveric transplantation and dialysis. When compared with mini-incision open donor nephrectomy, laparoscopic donor nephrectomy (LDN) is considered a cost-effective procedure. However, little is known on the cost-effectiveness of hand-assisted retroperitoneoscopic donor nephrectomy (HARP). This study evaluated the cost-effectiveness of HARP versus LDN.

Methods: Alongside a randomized controlled trial, the cost-effectiveness of HARP versus LDN was assessed. Eighty-six donors were included in the LDN group and 82 in the HARP-group. All in-hospital costs were recorded. During follow-up, return-to-work and other societal costs were documented up to 1 year. The Euroqol-5D questionnaire was administered preoperatively and 3, 7, 14, 28, 90, 180, and 365 days postoperatively to calculate quality-adjusted life years (QALYs).

Results: Mean total costs from a health-care perspective were $8935 for HARP and $8650 for LDN (p=0.25). Mean total costs from a societal perspective were $16357 for HARP and $16286 for LDN (p=0.79). On average, donors completely resumed their daytime jobs at day 54 in the HARP-group and at day 52 in the LDN-group (p=0.65). LDN resulted in a gain of 0.005 QALYs.

Conclusions: Absolute costs of both procedures are low. The differences in costs and QALYs between LDN and HARP are very small. The results of this study slightly favour LDN. However, as the measured differences are very mall, other arguments should determine the choice between HARP and LDN.

« Back to 2013 American Transplant Congress