Stringent adherence to a cytomegalovirus‐prevention protocol is associated with reduced overall costs in the first 6 months after kidney transplantation. Issue 3 (19th May 2015)

• Record Type: Journal Article
• Authors: Matter‐Walstra, K.W.; Greiner, M.; Cusini, A.; Schiesser, M.; Ledergerber, B.; Fehr, T.; Mueller, N.J.
• Is Part Of: Transplant infectious disease. Volume 17:Issue 3(2015)
• Page Start: 342
• Page End: 349
• Publication Date: 2015-05-19
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12379
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12379-abs-0001"> <title>Abstract</title> <sec id="tid12379-sec-0001" sec-type="section"> <title>Background</title> <p>We previously documented that a stringent implementation of a preemptive cytomegalovirus (CMV) prevention protocol reduced the number of CMV disease episodes after kidney transplantation, when compared with a routine preemptive protocol. The impact on overall costs was assessed.</p> </sec> <sec id="tid12379-sec-0002" sec-type="section"> <title>Methods</title> <p>Cost comparisons were made for inpatient and outpatient costs and overall costs, using costs provided by the financial department. Variables were analyzed using the Wilcoxon rank‐sum test. A multivariable global linear model evaluated the effect of all co‐variables on cost differences. In Cohort 1 (<italic>n</italic> = 84), 74% were followed with a standard CMV preemptive protocol, and 26% received prophylaxis. In Cohort 2 (<italic>n</italic> = 74), an intensified CMV surveillance protocol was applied in 74% of patients, and 26% were given prophylaxis.</p> </sec> <sec id="tid12379-sec-0003" sec-type="section"> <title>Results</title> <p>Overall, Cohort 1 had significantly higher treatment costs as compared with Cohort 2 (mean Swiss francs [CHF] 104, 548 and CHF 76, 983, respectively, <italic>P</italic> = 0.0005). Excluding patients who received prophylaxis reduced these costs to CHF 89, 318 in Cohort 1 and CHF 73, 652 in Cohort 2. Outcome between Cohort 1 and 2 was comparable.</p> </sec> <sec id="tid12379-sec-0004" sec-type="section"> <title>Conclusion</title> <p>A stringent adherence to the CMV prevention protocol was associated with a significant reduction in overall costs. Whether this benefit is because of the demonstrated reduction in the rate of CMV disease needs to be assessed in a randomized trial.</p> </sec> </abstract>