Table 4.

Results of CUA of CKD patients undergoing kidney transplant included in the 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

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

Dominant^a—The intervention is cost saving and improves health compared to the comparator; Dominated^b—The intervention is not cost saving and does not improves health compared to the comparator