HCV-Infected Kidney Transplant More Efficient in HCV-Infected
Increases quality-adjusted life expectancy, reduces costs versus transplant of HCV-uninfected kidney.
(HealthDay News) -- For patients with hepatitis C virus (HCV) infection with end-stage renal disease, transplant of an HCV-infected kidney followed by treatment is more cost-effective than transplant of an HCV-uninfected kidney, according to a study published online in the Annals of Internal Medicine.
Mark H. Eckman, MD, from the University of Cincinnati, and colleagues compared the cost-effectiveness of transplanting HCV-infected or HCV-uninfected kidneys into HCV-infected patients. Transplant of an HCV-infected kidney was followed by HCV treatment, while transplant of an uninfected kidney was preceded by treatment.
The researchers found that, compared with transplant of an uninfected kidney, preceded by treatment, transplant of an HCV-infected kidney, followed by HCV treatment, was more effective and less costly in base-case analysis; this was mainly due to longer wait times for uninfected kidneys. An average of 0.5 quality-adjusted life-years would be gained at a lifetime cost savings of $41,591 for a typical 57.8-year-old patient receiving hemodialysis. In sensitivity analysis, transplant of an HCV-infected kidney continued to be preferred. Unless the additional wait time for an uninfected kidney was less than 161 days, transplant of an HCV-uninfected kidney preceded by HCV treatment was not preferred.
"Transplanting HCV-infected kidneys into HCV-infected patients increased quality-adjusted life expectancy and reduced costs compared with transplanting HCV-uninfected kidneys into HCV-infected patients," the authors write.
The study was funded by a grant from Merck Sharp & Dohme.
Eckman MH, Woodle S, Thakar CV, Paterno E, and Sherman KE. Transplanting Hepatitis C Virus–Infected Versus Uninfected Kidneys Into Hepatitis C Virus–Infected Recipients: A Cost-Effectiveness Analysis. Ann Intern Med. DOI: 10.7326/M17-3088
Goldberg DS, Reese PP, et al. New Insights Into Optimal Timing of Hepatitis C Virus Treatment for Dialysis Patients Waitlisted for Kidney Transplant. Ann Intern Med. DOI: 10.7326/M18-1718