Journal article
Modeling the benefits and costs of integrating an acceptable HLA mismatch allocation model for highly sensitized patients
Transplantation, Vol.97(7), pp.769-774
2014
Abstract
Background
The Eurotransplant acceptable mismatch program has improved transplantation access for highly sensitized recipients. However, the benefits and costs of implementing such a program remain unknown.
Methods
Using decision analytical modeling, we compared the average waiting time for transplantation, overall survival gains (in life-years and quality-adjusted life-years gained), and costs of integrating an acceptable mismatch allocation model compared with the current deceased-donor kidney allocation model in Australia.
Results
Acceptable mismatches were identified in 12 of 28 (43%) highly sensitized recipients using HLAMatchmaker. Inclusion of acceptable mismatches in the current allocation model improved the transplantation access for four (14%) highly sensitized recipients, with an average reduction in waiting time of 34 months (from 86 to 52 months). Compared with the current allocation model, incorporating an acceptable mismatch allocation model achieved an overall lifetime gain of 0.034 quality-adjusted life-years and savings of over $4,000 per highly sensitized patient, with a small consequential loss of 0.005 quality-adjusted life-years and extra costs of $800 for every reallocated patient.
Conclusions
Despite modest overall health gains, application of an acceptable mismatch allocation model is an equitable approach to improve transplantation access for highly sensitized transplant candidates without compromising the overall health benefits among the other patients on the deceased-donor waitlist in Australia.
Details
- Title
- Modeling the benefits and costs of integrating an acceptable HLA mismatch allocation model for highly sensitized patients
- Authors/Creators
- H.D. Nguyen (Author/Creator)G. Wong (Author/Creator)K. Howard (Author/Creator)F.H.J. Claas (Author/Creator)J.C. Craig (Author/Creator)S. Fidler (Author/Creator) - School of Pathology and Laboratory MedicineL. D’Orsogna (Author/Creator)J.R. Chapman (Author/Creator)A. Irish (Author/Creator)P. Ferrari (Author/Creator) - School of Medicine and PharmacologyF.T. Christiansen (Author/Creator) - School of Pathology and Laboratory MedicineW.H. Lim (Author/Creator) - School of Medicine and Pharmacology
- Publication Details
- Transplantation, Vol.97(7), pp.769-774
- Publisher
- Lippincott, Williams & Wilkins
- Identifiers
- 991005544445807891
- Copyright
- © 2014 by Lippincott Williams & Wilkins
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- 1.157 Organ Donation & Transplantation
- 1.157.1540 Antibody-Mediated Rejection
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