St. Louis, May 17, 1999 -- A study of thousands of kidney transplants suggests that the long-term cost of caring for patients could drop dramatically if more received kidneys closely resembling their own organs.
Doctors are debating the importance of transplanting organs whose surface proteins are identical to a patient's other organs. Previous studies suggested that multiple differences in the surface markers, called HLA markers, had little effect on kidney rejection of transplanted kidneys.
In the new study of 27,050 kidney transplants, the investigators demonstrated a significant increase in the need for care within three years of transplantation as the number of mismatched surface markers increased.
"Although the transplanted kidney remains functional in patients with more mismatches, the patient doesn't do as well, and that fact makes it much more costly," says economist Mark A. Schnitzler, Ph.D., a research instructor at Washington University School of Medicine in St. Louis. Schnitzler will present the findings May 17 at the annual meeting of the American Society of Transplantation in Chicago.
Schnitzler and colleagues in the medical school's Pharmaco-Economic Transplant Research group compared national kidney transplant records from the United Network on Organ Sharing (UNOS) with Medicare claims for the same patients. All 27,050 had received an organ from a deceased donor between 1992 and 1997. They determined the cost of their care from 30 days after transplant until three years after transplantation.
The average cost to Medicare -- and thus to taxpayers -- of care within
three years was roughly $60,436 when the kidney had identical HLA markers to the
patient's own organs. The cost rose by 5 percent to 34 percent as the number of
mismatches increased from one to six:
UNOS gives a patient on the national waiting list top priority for a donor
kidney anywhere in the United States that has
Contact: Barbra Rodriguez
Washington University School of Medicine