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Table 4 Results of CUA of CKD patients undergoing kidney transplant included in the review

From: Cost-utility analysis in chronic kidney disease patients undergoing kidney transplant; what pays? A systematic review

Study Study population Intervention Comparator Incremental cost effectiveness ratio (ICER) Willingness to pay threshold Sensitivity analysis-method Sensitivity
analysis-results
CUA of transplanting infectious kidneys (n = 03)
 Kadatz et al. [26] Patients waitlisted for KT Transplanting a HCV- NAT positive deceased donor kidney followed by post-transplant direct acting anti-viral administration Remaining on the waitlist for a kidney transplant from an HCV NAT- negative donor ICER is US$ 56,018 if receiving a HCV NAT positive kidney shortens the wait-time by 1 year. Remaining on the waitlist for 2 or more years is dominatedb compared to receiving a HCV NAT positive kidney US $ 50,000 PSA, SA Robust
 Kiberd et al. [27] Patients waitlisted for KT Allocation polices based on donor and recipient HCV status Comparison between each option Option (b) over option (c)—ICER US$ 18,760/QALY.
Option (a) over option (b)—Dominatedb
Option (c) over option (a)—Dominanta
Not mentioned SA Variable
discard all HCV+ donors
screen all donors and transplant infected organs into HCV+ recipients only
ignore HCV status and transplant without screening
 Schweitzer et al. [34] Patients waitlisted for KT Transplant kidneys from both standard donors and CDC-IRDs Only transplant kidneys from standard donors. Discard kidneys from CDC-IRDs Dominanta Not mentioned OW, SA Robust
CUA of kidney allocation policies (n = 09)
 Axelrod et al. [21] Patients waitlisted for KT KDPI ≤85 DKT Patients continuing on HD US $ 83/QALY US $ 100,000 Not done
KDPI >85 DKT US $ 32,870/QALY
PHS increased risk DKT US $ 7944/QALY
HLA 0‐3 mismatch LKT Dominanta
HLA 4‐6 mismatch LKT Dominanta
ABOi LKT US $ 34,755/QALY
ILKT US $ 102,859/QALY
 Smith et al. [35] Patients waitlisted for KT A policy of transplanting the top 20% of the KDPI to candidates in the top 20% of expected survival Conventional allocation policy Dominanta Not mentioned OW Robust
 Mutinga et al. [31] Patients waitlisted for KT HLA-B locus not matched before kidney allocation HLA-B locus matched before kidney allocation US $ 7300 cost saving per lost QALY Not mentioned PSA, SA Robust
 Schnitzler et al. [33] Patients waitlisted for KT Accepting a ECD kidney Accepting a standard kidney ICER value not mentioned.
SD US $ 56,058/QALY
ECD US $ 72,838/QALY
Not mentioned OW Robust
 Bavanandan et al. [23] Patients waitlisted for KT Kidney transplantation using live donors Kidney transplantation using deceased donors Dominanta Not mentioned OW Robust
 Snyder et al. [36] Patients waitlisted for KT A waitlist with both DBD and DCD kidneys A waitlist only with DBD Dominanta Not mentioned OW, TW, PSA Robust
 Cavallo et al. [24] Patients waitlisted for KT Assumption of 10 extra DCD transplants per year after implementing the programme Alba [40] Baseline practice US $ 7025/QALY Not mentioned OW Variable
Assumption of 10% extra transplants from each donation type (DCD, DBD, live) per year after implementing the programme Alba [40] Baseline practice Dominanta OW Variable
 Barnieh et al. [22] Patients waitlisted for KT A payment of US $8000 (2010) to all the living donors, which would expect the annual transplant rate to increase by 5%. Current KT practice Dominanta Not mentioned OW, TW, PSA Variable
 Matas et al. [29] Patients waitlisted for KT Patients receiving a paid living unrelated donor kidney Patients continuing on HD It would be cost-effective to add one vendor to the donor pool if the payment made to that vendor for donation was no more than US $351,065 Not mentioned OW Variable
CUA of technology used in KT (n = 04)
 Nguyen et al. [32] KT recipients (DKT and LKT) Using bead-based multiplex assays (threshold MFI level 500) with CDC Only CDC Dominanta Not mentioned OW, PSA Robust
 McLaughlin et al. [30] Patients undergoing DKT Flow screening only, where patients’ immunological risks were stratified using the results of FCXM and flow micro-bead PRA Serological screening only, where patients’ immunological risks were stratified using the result of AHG enhanced CDCXM and PRA titer only Dominanta Not mentioned OW Robust
 Groen et al. [25] Patients undergoing KT Hypothermic machine preservation as the organ preservation method in KT Use of Static cold storage Dominanta Not mentioned Bootstrapping Robust
 Liem et al. [28] Live kidney donors undergoing pre-operative imaging Different combinations of strategies; MRIA, SCTA, DSA with MRA, MRIA and DSA if MRIA inconclusive, MRIA with SCTA Pre-operative imaging DSA DSA dominated all the imaging strategies Not mentioned OW, TW Variable
  1. HCV NAT Hepatitis C nucleic acid test, HCV Hepatitis C virus, CDC IRDs Centers for Disease Control classified increased risk donors, KDPI Kidney Donor Profile Index, DKT deceased kidney transplant, LKT living kidney transplant, HD Haemodialysis, PHS US Public Health Service, ILKT HLA incompatible living kidney transplant, ECD expanded criteria donor, DBD donation after brain death, DCD donation after cardiac death, CDC complement-dependent cytotoxicity, MFI mean fluorescence intensity, FCXM flow cytometry cross matching, PRA panel reactive antibody, CDCXM complement-dependent cytotoxicity crossmatch, AGH antihuman globulin, MRI A MRI Angiography, SCTA spiral CT angiography, DSA digital subtraction angiography, PSA probabilistic sensitivity analysis, OW on-way sensitivity analysis, TW two-way sensitivity analysis, SA scenario analysis
  2. Dominanta—The intervention is cost saving and improves health compared to the comparator; Dominatedb—The intervention is not cost saving and does not improves health compared to the comparator