{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T12:24:44Z","timestamp":1784809484827,"version":"3.55.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,3]],"date-time":"2019-08-03T00:00:00Z","timestamp":1564790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"French Ministry of Health","award":["DHOS STIC 2009"],"award-info":[{"award-number":["DHOS STIC 2009"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In Europe, transplantation centres use different nephrectomy techniques: open surgery, and standard, hand-assisted and robot-assisted laparoscopies. Few studies have analysed the disparity in costs and clinical outcomes between techniques. Since donors are healthy patients expecting minimum pain and fast recovery, this study aimed to compare the cost-effectiveness of four nephrectomy techniques focusing on early surgical outcomes, an essential in the donation act.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A micro-costing approach was used to estimate the cost of implementation from a hospital perspective. Estimates took into account sterilization costs for multiple-use equipment, costs for purchasing single-use equipment, staff and analgesics. The study recruited donors in 20 centres in France. Quality of life by EuroQol-5D was assessed preoperatively, and 4 and 90\u2009days post-operatively. Two effectiveness indicators were built: quality-of-life recovery and post-operative pain days averted (PPDA). The study was registered at ClinicalTrials.gov NCT02830568, on 10 June 2010.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 264 donors were included; they underwent open surgery (n\u2009=\u200965), and standard (n\u2009=\u200965), hand-assisted (n\u2009=\u200965) and robot-assisted laparoscopies (n\u2009=\u200969). Use of the nephrectomy techniques differed greatly in cost of implementation and immediate post-operative outcomes but not in clinical outcomes at 90\u2009days. At 4\u2009days, hand-assisted laparoscopy provided the lowest cost per quality-of-life recovery unit of effectiveness (%) and PPDA (days) (\u20ac2056\/40.1%\/2.3\u2009days, respectively). Robot-assisted laparoscopy was associated with the best post-operative outcomes but with the highest cost (\u20ac3430\/59.1%\/2.6\u2009days).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Hand-assisted, standard and robot-assisted laparoscopies are cost-effective techniques compared with open surgery. Hand-assisted surgery is the most cost-effective procedure. Robot-assisted surgery requires more healthcare resource use but enables the best clinical outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfz143","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T14:39:30Z","timestamp":1561473570000},"page":"2004-2012","source":"Crossref","is-referenced-by-count":24,"title":["Cost-effectiveness of four living-donor nephrectomy techniques from a hospital perspective"],"prefix":"10.1093","volume":"35","author":[{"given":"Hamza","family":"Achit","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Centre CIC 1433 Inserm, University Hospital of Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Guillemin","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Centre CIC 1433 Inserm, University Hospital of Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital of Nantes, Site H\u00f4tel-Dieu, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Ladri\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital of Nancy, Site Brabois, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Baumann","sequence":"additional","affiliation":[{"name":"Department of Methodology, Promotion and Investigation, University Hospital of Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Frimat","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital of Nancy, Site Brabois, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kossar","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Centre CIC 1433 Inserm, University Hospital of Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Hubert","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital of Nancy, Site Brabois, Nancy, France"},{"name":"IADI-UL-INSERM (U1254), University Hospital of Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,3]]},"reference":[{"key":"2020110509411864100_gfz143-B1","first-page":"A4796","article-title":"In Denmark kidney transplantation is more cost-effective than dialysis","volume":"61","author":"Jensen","year":"2014","journal-title":"Dan Med J"},{"key":"2020110509411864100_gfz143-B2","doi-asserted-by":"crossref","first-page":"2988","DOI":"10.1093\/ndt\/gfq780","article-title":"Cost-effectiveness analysis of renal replacement therapy in Austria","volume":"26","author":"Haller","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"2020110509411864100_gfz143-B3","doi-asserted-by":"crossref","first-page":"2054","DOI":"10.1093\/ndt\/gfv300","article-title":"Economic impact of a modification of the treatment trajectories of patients with end-stage renal disease","volume":"30","author":"Couchoud","year":"2015","journal-title":"Nephrol Dial Transplant"},{"key":"2020110509411864100_gfz143-B4","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1097\/01.tp.0000235511.19629.0d","article-title":"The current practice of live donor nephrectomy in Europe","volume":"82","author":"Kok","year":"2006","journal-title":"Transplantation"},{"key":"2020110509411864100_gfz143-B5","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1093\/ndt\/gfi150","article-title":"Robot-assisted laparoscopic and open live-donor nephrectomy: a comparison of donor morbidity and early renal allograft outcomes","volume":"21","author":"Renoult","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"2020110509411864100_gfz143-B6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/TP.0b013e318199cfc9","article-title":"Cost effectiveness of open versus laparoscopic living-donor nephrectomy","volume":"87","author":"Hamidi","year":"2009","journal-title":"Transplantation"},{"key":"2020110509411864100_gfz143-B7","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1097\/01.tp.0000267149.64831.08","article-title":"Cost effectiveness of laparoscopic versus mini-incision open donor nephrectomy: a randomized study","volume":"83","author":"Kok","year":"2007","journal-title":"Transplantation"},{"key":"2020110509411864100_gfz143-B8","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/TP.0b013e318296ca25","article-title":"Cost-effectiveness of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy. 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