St. Louis, May 20, 1999 -- Dialysis is much costlier to maintain than giving a person a kidney from a living donor according to a study of more than 50,000 transplant recipients.
The study suggests that the total cost of care within five years of transplant surgery is roughly $47,000 less than dialysis treatments would be for five years. Giving people kidneys from deceased donors, the most plentiful current source, also saves about $19,000 over the same period.
"If people think that a transplant is an incredibly expensive thing, they should know that its initial expense is offset by cost savings in the long run," says Mark A. Schnitlzer, Ph.D., an economist and research instructor at Washington University School of Medicine in St. Louis who led the study.
The findings will be presented May 20 at the national meeting of the American Society of Transplant Surgeons in Chicago. Craig, R. Smith, M.D., a surgical resident at the medical school, will make the presentation.
Doctors already knew that regular visits to dialysis centers are more costly than kidney transplants. A dialysis machine takes over the main job of the kidney, filtering the body's fluids. But the machine can't filter as well or perform the organ's other functions, so patients become weak and susceptible to illnesses.
"Every time we do a living donor transplant, we save taxpayers $50,000 five years out and presumably even more for the lifetime of the transplant," Schnitzler says. Half of the people who receive living donor kidneys still have them after 15 years, and kidneys from cadavers tend to last 10 years on average.
In the study, Schnitzler and colleagues in the medical school's Pharmaco-Economic Transplant group compared national kidney transplant records from the United Network for Organ Sharing (UNOS) with Medicare claims for the same patients. They analyzed records of 13,754 people who received living donor kidneys and 42,868 who received kidneys from cadavers.
They then estimated how much it would have cost to keep these patients on dialysis for five years using dialysis costs from the year prior to transplantation. According to the United States Renal Data Systems, Medicare pays an average of $51,000 annually for care of dialysis patients.
Schnitzler says he hopes the findings will spur efforts to increase organ donations, especially from living donor organs. Most often, living kidney donations come from a patient's relatives or spouses.
Direct family members may be unable to donate, however. This is especially true of women who have developed an intolerance to a husband's or a child's tissue during pregnancy.