Long term medical and economical benefit of machine perfusion (MP) kidney storage in comparison to cold storage (CS)

Despite documented positive effect of MachinePerfusion (MP) on long-term kidneys-graft function its wide use is restricted due to higher costs. The aim of this study was to analyze the difference in costs of kidney transplantation in patients who received organ stored in ColdStorage (CS) vs those who received kidneys stored with MP.

Analysis was done on kidney transplantations performed between 1994-1999 in 415 patients.. Kidneys were not randomized to MP or to CS: 188 kidneys were stored in CS, 227-in MP. Recipients didn't differ in regard to the age, sex, PRA, HLA mismatch, and immunosupression.The costs of organ procurement,transportation,surgical and anesthetic procedures, episodes of acute rejection were similar for both group of patients and were not included into the analysis. Costs of first month post-transplantation included: the cost of MP, post-transplantation hemodialysis, costs of hospitalization.Analysis of costs difference in between two groups of patients during follow-up included the costs of immunosupression and the monthly cost of dialysis. Statistical analysis was done using linear regression model.

Long graft survival was 68,2% in MP group vs.54,2% in CS group (p=0.02) Return to dialysis treatment was 20% in MP group vs.36% in CS group (p=0.01).Since 2 month post-transplant, mean cost of treatment for one patient was higher of 59,7 USD in CS group vs. MP group (p<0.001)in each month. Costs of investments on MP were equalized in 16 month post-transplantation.

Despite higher costs of MP use in the first month post transplantation, it is money-saving method of kidneys preservation and its cost of use, are equalized after 16 months post transplantation.