Logo image
Back
Outcomes and Cost of Donor Nephrectomy Across Surgical Specialties and Operative Approaches
Journal article   Peer reviewed

Outcomes and Cost of Donor Nephrectomy Across Surgical Specialties and Operative Approaches

Jack C. Millot, Ilon Weinstein, Camilo Arenas-Gallo, Adithya Balasubramanian, Stephen Rhodes, Mollie Goldman, Shany Picciotto and Jonathan E. Shoag
Urology practice, v 11(6), pp 921-929
01 Nov 2024
DOI: https://doi.org/10.1097/UPJ.0000000000000673
PMID: 39196727

Abstract

Life Sciences & Biomedicine Science & Technology Urology & Nephrology
Introduction: Live donor nephrectomy (LDN) is performed by various specialty surgeons, including urologists, general surgeons, and transplant surgeons. However, national practice patterns and outcomes associated with surgeon specialty have not been previously explored. Here, we investigate surgeon specialty trends, perioperative complications, hospital length of stay, cost, and charge for LDN according to surgeon specialty. Methods: Patients who underwent LDN from 2000 to quarter 1 of 2020 were identified in the Premier Healthcare Database. Associations between physician specialty and 3-month complications, hospital length of stay, institutional cost, and patient charge for LDN procedures were examined using multivariable regression. Results: We identified 11,418 patients who underwent LDN. Of these cases, 3387 (29.7%) were performed by urologists, 3127 (27.4%) by transplant surgeons, 3928 (34.4%) by general surgeons, and 976 (8.5%) by other specialties. In 2000, urologists performed 35.92% of LDNs, decreasing to 18.91% by 2019 (P < .001 for trend). In the last 5 years, we found no significant difference in complications or length of stay according to surgeon specialty. LDNs performed by a urologist ($57,289, 95% CI $49,292-$66,582) were associated with lower patient charges than those performed by a general surgeon ($68,501, 95% CI $59,090-$79,412) or transplant surgeon ($62,639, 95% CI $53,993-$72,670). Conclusions: From 2000 to 2019, the proportion of LDNs performed by urologists significantly decreased, while the proportion for transplant surgeons significantly increased, with no significant differences in complications or length of stay across specialties. However, surgeries performed by urologists cost hospitals less and had lower charges for patients.

Metrics

1 Record Views
1 citations in Web of Science

Details

Logo image