Costs Associated With the Treatment of Surgical Site Infections in Solid Organ Transplant Recipients: A Scoping Review
Author(s)
Ramon Antonio Oliveira, MSc, RN, ScD1, José Nacélio da Silva Ferreira, MSc Student2, Silvia Regina Secoli, PhD, professor,3.
1University of São Paulo, São Paulo, Brazil, 2Universidade de São Paulo, Escola de Enfermagem, São Paulo, Brazil, 3Universidade de São Paulo, São Paulo, Brazil.
1University of São Paulo, São Paulo, Brazil, 2Universidade de São Paulo, Escola de Enfermagem, São Paulo, Brazil, 3Universidade de São Paulo, São Paulo, Brazil.
OBJECTIVES: To map the available evidence on the direct costs associated with the treatment of surgical site infections (SSIs) in adult solid organ transplant recipients.
METHODS: Scoping review conducted in accordance with the guidelines established by the JBI. Eight electronic databases and sources of gray literature were searched in November 2024. Cost estimates were converted into a common currency, the US Dollar 2024, using a tool developed by the Campbell and Cochrane collaborations.
RESULTS: A total of 4,145 records were retrieved. Of these, 17 full-text manuscripts and their reference lists were reviewed. The final sample consisted of five studies. The majority of studies (60%) were conducted in the United States. Three investigations (60.0%) included liver transplant recipients, and two (40.0%) included kidney transplant recipients. All reports described retrospective cohort studies. Among liver transplant recipients, the incidence of SSIs ranged from 15.7% to 37.8%, and among kidney transplant recipients, from 4.1% to 18.5%. The overall cost of liver transplantation in patients without SSIs ranged from USD 39,480 to USD 333,235, and for kidney transplantation from USD 8,684 to USD 114,562. The cost of treating SSIs, adjusted for severity, ranged from USD 17,248 to USD 246,548 for liver transplant recipients and was USD 20,183 for kidney transplant recipients. The most frequently reported cost parameters were hospital stay (100.0%), medications (60.0%), laboratory tests (60.0%), and human resources (60.0%). None of the included studies provided a detailed micro-costing analysis of the cost parameters.
CONCLUSIONS: SSIs, in both types of transplants, represent a significant financial burden and may compromise the sustainability of healthcare institutions and systems, particularly due to increased hospitalization time. However, methodological limitations of the studies, namely: the lack of detailed information on the constituent cost categories, hinder the comparison of overall costs based on the types of resources consumed.
METHODS: Scoping review conducted in accordance with the guidelines established by the JBI. Eight electronic databases and sources of gray literature were searched in November 2024. Cost estimates were converted into a common currency, the US Dollar 2024, using a tool developed by the Campbell and Cochrane collaborations.
RESULTS: A total of 4,145 records were retrieved. Of these, 17 full-text manuscripts and their reference lists were reviewed. The final sample consisted of five studies. The majority of studies (60%) were conducted in the United States. Three investigations (60.0%) included liver transplant recipients, and two (40.0%) included kidney transplant recipients. All reports described retrospective cohort studies. Among liver transplant recipients, the incidence of SSIs ranged from 15.7% to 37.8%, and among kidney transplant recipients, from 4.1% to 18.5%. The overall cost of liver transplantation in patients without SSIs ranged from USD 39,480 to USD 333,235, and for kidney transplantation from USD 8,684 to USD 114,562. The cost of treating SSIs, adjusted for severity, ranged from USD 17,248 to USD 246,548 for liver transplant recipients and was USD 20,183 for kidney transplant recipients. The most frequently reported cost parameters were hospital stay (100.0%), medications (60.0%), laboratory tests (60.0%), and human resources (60.0%). None of the included studies provided a detailed micro-costing analysis of the cost parameters.
CONCLUSIONS: SSIs, in both types of transplants, represent a significant financial burden and may compromise the sustainability of healthcare institutions and systems, particularly due to increased hospitalization time. However, methodological limitations of the studies, namely: the lack of detailed information on the constituent cost categories, hinder the comparison of overall costs based on the types of resources consumed.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE290
Topic
Economic Evaluation, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies