Cost-effectiveness of kidney transplantation from DCD in Italy.

•The main goal of our hospital is to increase and improve transplantation medicine. Thus, in the early 2000s, we initiated a project for organ donation after cardiac death (DCD). Determination of death requires a 20-minute flat electrocardiogram, according to Italian law. After animal studies showed organ viability over the 20-minute nontouch period, the local and the national bioethics committees allowed project planning.•In 2007, the global financial crisis became real, prompting us to analyze transplantation costs in detail. We also compared brain-dead donations versus DCD versus hemodialysis. We concluded that the DCD policy is a cost-effective procedure compared with present end-stage renal disease treatment options.