1Department of Urology, Merkur University Hospital, Zagreb, Croatia; 2Department of Surgery, Merkur University Hospital, Zagreb, Croatia; 3Department of Nephrology, University Hospital Crosshouse, Kiemarnock, UK.
Acta Clin Croat. 2021 Jun;60(2):178-183. doi: 10.20471/acc.2021.60.02.02.
The aim was to determine the cost of hospitalization for a transplant procedure and identify the independent variables associated with the cost of transplantation. The investigation was designed as a retrospective single-center cohort study conducted at a tertiary university hospital transplant center in Zagreb, Croatia. The study included 219 consecutive kidney recipients transplanted during the 2007-2013 period at the Merkur University Hospital. There were 141 male and 78 female patients having undergone kidney transplantation during the study period. The majority of kidney transplants were from a deceased donor (n=179), while 40 were from a living donor. The mean cost of a transplantation was 86,140±42,240 HRK (11,460±5,600 €), ranging from 29,000 HRK (3,860 €) to 408,000 HRK (54,000 €). In the bivariate analysis, the variables associated with the cost of transplantation were the length of hospital stay, delayed graft function, death of the patient, graft loss, use of steroids, and death-censored graft loss. In the multivariate analysis, delayed graft function was the only statistically significant variable for the cost of transplantation. Since only delayed graft function had an impact on the cost of transplantation in this study, certain steps such as shortening of the cold ischemia time (better organization of organ transport), better education of family members for living donors, and higher percentage of patients on peritoneal dialysis should be taken to lower the percentage of delayed graft function.
目的是确定移植手术的住院费用，并确定与移植费用相关的独立变量。本研究设计为回顾性单中心队列研究，在克罗地亚萨格勒布的一家三级大学医院移植中心进行。该研究纳入了 2007 年至 2013 年期间在默克大学医院接受肾脏移植的 219 例连续肾脏受者。患者中男性 141 例，女性 78 例。在研究期间，有 179 例接受了来自已故供者的肾脏移植，40 例接受了来自活体供者的肾脏移植。肾脏移植的平均费用为 86,140±42,240 HRK（11,460±5,600€），范围为 29,000 HRK（3,860€）至 408,000 HRK（54,000€）。在单变量分析中，与移植费用相关的变量是住院时间、移植物功能延迟、患者死亡、移植物丢失、使用类固醇和受死亡影响的移植物丢失。在多变量分析中，移植物功能延迟是移植费用的唯一具有统计学意义的变量。由于在本研究中只有移植物功能延迟对移植费用有影响，因此应该采取某些措施，如缩短冷缺血时间（更好地组织器官运输）、对活体供者的家属进行更好的教育，以及提高接受腹膜透析的患者比例，以降低移植物功能延迟的比例。
