Abstract:
BACKGROUND:Caring for patients with end-stage renal disease (ESRD) is resource intense, and health care costs for this small segment of the population continue to rise. When compared to long-term dialysis as a therapy for ESRD, kidney transplantation increases survival, improves quality of life, and is cost saving. METHODS:We used decision analytic techniques to determine if cadaveric kidney transplantation is cost-effective in all age groups. We then looked at the impact of a strategy of restricting access to transplantation to those under 60 years of age to determine the impact on overall clinical outcomes and costs, as well as the outcomes and costs within each age group. RESULTS:Equal access to cadaveric kidney transplantation resulted in an increase in expected life years (7.4 vs 6.7 years) and a significant cost savings ($376,577 vs $568,670 per patient) compared to a strategy of long-term dialysis therapy over a 25-year time horizon. This pattern was seen for the overall cohort, and for all four age groups individually. Restricting access to transplantation to patients under the age of 60 resulted in only a very small improvement in expected life years and small cost savings under base-case assumptions. As expected, older patients were adversely impacted by this strategy. CONCLUSION:We have shown that transplantation is cost-effective for all age groups. A strategy of restricting access to transplantation to younger patients does not result in large cost savings and provides only small improvements in expected life-years at the expense of significantly worse outcomes in older patients.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Quinn RR,Manns BJ,McLaughlin KMdoi
10.1016/j.transproceed.2007.03.019subject
Has Abstractpub_date
2007-06-01 00:00:00pages
1362-7issue
5eissn
0041-1345issn
1873-2623pii
S0041-1345(07)00299-0journal_volume
39pub_type
杂志文章abstract:BACKGROUND:We evaluated the outcome of combined liver-lung transplantation (L-LTx) in cystic fibrosis (CF) patients with liver transplantation (LTx) for CF liver disease. METHODS:The United Network for Organ Sharing (UNOS) data were analyzed from October 1987 to August 2009. RESULTS:Of 294 patients (210 children), 26...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.02.033
更新日期:2013-01-01 00:00:00
abstract::Bacterial infections are a contraindication to organ transplantation, but infective endocarditis may require heart transplantation when otherwise untreatable. We describe a heart transplant patient with cardiomyopathy and ongoing defibrillator endocarditis due to Staphylococcus epidermidis. An initial attempt at percu...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.transproceed.2010.09.095
更新日期:2011-01-01 00:00:00
abstract::Hematopoietic stem cell transplantation (HSCT) is the treatment of choice for children and certain adults with malignant and nonmalignant hematologic disease. Since viral infections are the major problem, this study examined those that might potentially be transmitted to HSCT recipients via bone marrow (BM) versus umb...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.07.007
更新日期:2005-09-01 00:00:00
abstract:AIMS:We report a single-center experience of islet allogeneic transplantation in islet after kidney (IAK) and simultaneous islet-kidney (SIK) type 1 diabetic recipients using a steroid-free immunosuppressive regimen. METHODS:Eight patients received 12 islet infusions in 5 IAK and 3 SIK procedures. Median age was 51 ye...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.04.027
更新日期:2004-05-01 00:00:00
abstract::The primary cause of morbidity and mortality in renal transplantation is cardiovascular disease. Increased oxidative stress implies a greater degree of atherogenesis in these patients. N-acetylcysteine (NAC) which has a thiol group that is the source of l-cysteine and reduced glutathione, acts against atherosclerosis ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.109
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:A severe shortage in donor organs is the major driver for organ transplantation-related crimes. The Declaration of Istanbul 2008 (DOI) was created to stop such crimes. We investigated the impact of DOI on Internet reporting of transplantation-related crimes. METHODS:We conducted Google Advanced Searches to ...
journal_title:Transplantation proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/j.transproceed.2019.10.011
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:We compared single-shot epidural analgesia (20 mL 0.125% levobupivacaine and 3 mg diamorphine) followed by regular tramadol versus morphine patient-controlled analgesia (PCA) for postoperative pain following donor nephrectomy. METHODS:We retrospectively evaluated 12 patients who received single-shot epidural...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.08.116
更新日期:2011-12-01 00:00:00
abstract::This article seeks to standardize an experimental model of liver ischemia-reperfusion in rats following hemorrhagic shock modulated by N-acetylcysteine (NAC). Twenty-seven adult Wistar rats were randomized into three groups: the HS-IR-Garm underwent hemorrhagic shock with selective hepatic ischemia followed by reperfu...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.03.047
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:We explored relationships between blood levels of fingolimod (FTY720) and everolimus versus treated biopsy-proven acute rejection (BPAR) in an open-label trial in de novo kidney transplant recipients. METHODS:Patients (n = 52) who fulfilled predefined criteria placing them at increased risk of delayed graft ...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.transproceed.2006.10.084
更新日期:2006-12-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to assess nephroprotective influence of intravenous N-acetylcysteine (NAC) on renal function after radiocontrast use in calcineurin inhibitor-treated patients after orthotopic heart transplantation (OHT). MATERIALS AND METHODS:We analyzed the results of 112 consecutive coronary a...
journal_title:Transplantation proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.transproceed.2007.08.057
更新日期:2007-11-01 00:00:00
abstract::By understanding the size and characteristics of the potential donor pool, the concentration and location of the potential donors and factors influencing low rates of donation, it is possible to identify opportunities to improve the organ donation system. The exact donor gap needs to be established for each hospital/a...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0041-1345(96)00691-4
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:This study aimed to assess the impact of early incentive spirometry on the incidence of chest infection in patients undergoing laparoscopic donor nephrectomy. METHODS:A retrospective review on all consecutive laparoscopic donor nephrectomies (LDN) performed at a single institution from January 2008 to Augus...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.01.036
更新日期:2013-05-01 00:00:00
abstract::In September 2001, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) founded the Collaborative Islet Transplant Registry (CITR). Each year, CITR produces a complete set of analyses available to the public. In its second year, CITR represents the efforts of 19 North American islet transplant ...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2006.10.014
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The risk of the development of renal cell cancer (RCC) in renal transplant recipients is several times higher than the general population. There can often be a delay between initial radiological imaging and patients undergoing renal transplantation. We present and evaluate the prevalence and clinical charact...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2015.06.009
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Right-lobe living-donor liver transplantation (RLDLT) is an excellent option to reduce donor shortages for adult patients with acute liver failure (ALF). The aim of this study was to evaluate the etiologies and outcomes of 30 consecutive adult patients who underwent emergency RLDLT for ALF. METHODS:Between ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.10.056
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of transplants performed with a false-negative cytotoxicity cross-match and to analyze the clinical relevance of alloantibodies (Ab) detected only by flow cytometry (flow). METHODS:We studied 66 patients undergoing kidney transplantation from a cadaveric donor. All patients had a ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.05.040
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Umbilical cord blood (UCB) contains stem cells and may be an alternative source to bone marrow and peripheral blood stem cells for allogeneic transplantation for the treatment of hematologic malignancies and genetic disorders. Many UCB banks have been established worldwide to quickly provide high quality mat...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.06.065
更新日期:2005-07-01 00:00:00
abstract:AIM:Allograft steatosis is an emerging concern after liver transplantation (LT). The use of transient elastography (TE) with controlled attenuation parameter (CAP) may facilitate early detection of and intervention for allograft steatosis. This study aimed to evaluate the prevalence and risk factors of allograft steato...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.160
更新日期:2021-01-01 00:00:00
abstract::The purpose of this research was to determine the levels of anxiety and depression and the need for training of patients who had undergone liver transplantation. This descriptive research included patients who had undergone liver transplantation at least 1 month prior and had follow-up between June and November 2006. ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.11.012
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The impact of specific HLA antibodies on the allograft function in the Luminex era is not clearly known. This study aimed to investigate kidney transplantation outcomes in patients with different anti-HLA antibody status as detected by Luminex PRA. METHODS:This retrospective study included 106 deceased-dono...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.02.029
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to examine which demographic and comorbidity factors affected the activation of patients with end-stage renal disease on the national kidney transplantation waiting list. METHODS:This was a prospective cohort study across 13 transplantation centers in the United Kingdom from Octobe...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2013.03.033
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The evaluation of a potential living kidney donor (LKD) leads to exclusion of at least 50% of candidates. The aim of this study was to analyze the reasons for exclusion of potential LKDs referred to our center. METHODS:We retrospectively analyzed historic and clinical data of all potential LKDs who were eva...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.08.001
更新日期:2013-09-01 00:00:00
abstract::Leishmaniasis is an infection caused by protozoa of the genus Leishmania, transmitted by sandflies and endemic to more than 88 countries. Visceral leishmaniasis in immunosuppressed patients is a growing concern. We report the case of a 61-year-old male patient with a previous history of alcoholic cirrhosis and portal ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.01.069
更新日期:2020-06-01 00:00:00
abstract::The pancreas of the dog was divided into segments of left lobe (tail), body and uncinate, but with in-situ blood supply to each segment intact, and comparisons within the same dog were made of various techniques of handling the pancreatic duct. Ligating the duct or allowing it to drain freely into the peritoneal cavit...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00
abstract::It is well known that interferon-gamma (IFN-gamma) not only plays a critical role in antigen-dependent but also in antigen-independent tissue injury; however, it is not clear how tolerance induction affects the actions of IFN-gamma in the transplant setting. To address this question, we compared the effects of IFN-gam...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.10.119
更新日期:2006-12-01 00:00:00
abstract::Coronavirus disease 2019 (COVID-19) has been recently declared a global pandemic. As of June 5, 2020, over 75,000 cases have been reported with nearly 2500 deaths in India alone. COVID-19 has severely impacted deceased donor liver transplant (DDLT) programs throughout the world. Acceptance of deceased liver donors has...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.06.004
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The absolute risk of fractures in renal transplant patients is 3 times that of matched controls. Most of the symptomatic fractures are peripheral, suggesting a greater compromise of cortical bone. Peripheral quantitative computed tomography (pQCT) is a new imaging technique that allows separate noninvasive e...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.12.056
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:Living donor kidney transplant relieves the disease burden of patients with end-stage renal disease but may shorten donor life expectancy; however, their quality of life (QOL) is preserved. Nevertheless, the magnitude of the net gain of this procedure is unknown. We evaluated the QOL of both donors and recip...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.01.049
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The effectiveness of everolimus (EVR) for ABO-incompatible (ABOi) kidney transplantation is unknown. We evaluated outcomes of conversion from steroid to EVR in ABOi kidney transplant recipients. METHODS:We performed a retrospective observational cohort study of 33 de novo consecutive adult ABOi living donor...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.01.028
更新日期:2018-05-01 00:00:00
abstract::Despite the improved overall outcomes of liver transplantation as a result of advances in surgical techniques and improved immunosuppressive control, biliary complications (BCs) continue to be the most common cause of morbidity in liver transplant recipients. The objectives of this study were to analyze the incidence,...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.07.073
更新日期:2012-09-01 00:00:00