Elsevier

Transplantation Proceedings

Volume 47, Issue 1, January–February 2015, Pages 30-33
Transplantation Proceedings

3rd Congress of the Spanish Transplantation Society
Kidney transplantation
Economic Analysis of the Treatment of End-stage Renal Disease Treatment: Living-donor Kidney Transplantation Versus Hemodialysis

https://doi.org/10.1016/j.transproceed.2014.12.005Get rights and content

Abstract

Introduction

End-stage renal disease (ESRD) is a major public health problem in the Spanish health system. Kidney transplantation is the treatment of choice, offering better survival and cost-effectiveness than other alternatives. This study aimed to compare the cost of living-donor kidney transplantation (LDKT) during the first year after transplantation with that of hemodialysis (HD).

Method

A prospective, descriptive study of cost and efficacy was performed in the Hospital Clinic in Barcelona from January to December 2011. We included 106 patients (57 undergoing HD and 49 receiving a LDKT). The costs of LDKT (donor and recipient) and HD were calculated based on our economic database program.

Results

The mean age of recipients and donors was 46 ± 15 and 52 ± 10 years, respectively, and 67% of the recipients were men. In HD patients, the mean age was 67 ± 11 years and 62% were men. The total cost of LDKT was €29,897.91 (€8,128.44 for donors and €21,769.47 for recipients). The total cost of HD was €43,000.88 (€37,917 for HD and related procedures plus €5,082 for transport). LDKT represented a savings of €13,102.97 per patient/year and the payback period was less than 1 year. Quality-adjusted life years were higher in LDKT than in HD patients.

Conclusion

LDKT is cost effective during the first year after transplantation and is associated with enhanced quality of life. From both the medical and economic points of view, pre-emptive LDKD should be encouraged in Spain to reduce the health budget for ESRD.

Section snippets

Method

A prospective, descriptive study of costs and efficacy was performed in the Hospital Clínic de Barcelona from January to December 2011. We included 106 patients (57 undergoing HD and 49 who receiving LDKT). The costs of LDKT (donor and recipient) and HD were calculated, based on our financial data program.

Demographic Data

The mean age of transplant recipients was 46 ± 15 years and that of donors was 52 ± 10 years. A total of 67% of the recipients were men, the mean body mass index was 26.22 ± 11 in the recipient group, and for 89% it was a pre-emptive transplantation. The main ESRD cause was interstitial in 20%. The mean age of patients undergoing HD was 67 ± 11 years and 62% were men. The cause of the ESRD was diabetes in 29.8%. The time on HD was 27 ± 10 months, 53 patients were on the transplant waiting list

Discussion

This study shows that LDKT is more cost-effective than HD, representing a savings of 13,102.97€ per patient/y. The cost recovery period for this type of transplantation is less than a year, and patients have enhanced quality of life.

Renal transplantation is the treatment of choice for suitable candidates who have CKD because it offers better survival than other alternatives, improves quality of life, and is cost-effective [4]. LDKT is a common procedure that produces excellent long-term

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