Economic impact of delayed graft function and suboptimal kidneys
Renal transplantation remains the cost-effective treatment of choice for end-stage renal disease. However, the gap between supply and demand for cadaveric kidneys only continues to widen. To expand the donor pool, many transplant centers now accept organs from donors that only a few years ago would have been rejected. The use of kidneys from ECDs and those with a high likelihood of DGF can have a significant impact on graft survival and cost. The average cost of initial hospitalization for patients undergoing cadaveric renal transplant in which there is DGF is approximately $25,000 higher per patient than when there is no DGF. Moreover, the use of an ECD kidney increases the average cost by $12,000 per patient. When the clinical manifestations of DGF and ECD kidneys, such as increased rate of acute rejection and worse graft survival, are taken into account the economic impact is expanded. In the past decade, pharmaceutical companies have focused their resources far more on new immunosuppressive agents rather than treatments to improve early graft function or reduce alloantigen independent injury and inflammation. As the negative economic and clinical impacts of DGF and ECD kidney become clearer, there may be more incentive for scientific and clinical research in this area to improve long-term and short-term graft survival. Copyright © 1999 by W.B. Saunders Company.
Freedland, SJ; Shoskes, DA
Volume / Issue
Start / End Page
International Standard Serial Number (ISSN)
Digital Object Identifier (DOI)