%A Cooper,Matthew
%A Schnitzler,Mark
%A Nilubol,Chanigan
%A Wang,Weiying
%A Wu,Zheng
%A Nordyke,Robert J.
%D 2022
%J Transplant International
%C
%F
%G English
%K Kidney transplant,graft failure,estimated glomerular filtration rate,graft function,cost
%Q
%R 10.3389/ti.2022.10422
%W
%L
%M
%P
%7
%8 2022-May-27
%9 Brief Research Report
%#
%! Costs and renal function
%*
%<
%T Costs in the Year Following Deceased Donor Kidney Transplantation: Relationships With Renal Function and Graft Failure
%U https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10422
%V 35
%0 JOURNAL ARTICLE
%@ 1432-2277
%X Relationships between renal function and medical costs for deceased donor kidney transplant recipients are not fully quantified post-transplant. We describe these relationships with renal function measured by estimated glomerular filtration rate (eGFR) and graft failure. The United States Renal Data System identified adults receiving single-organ deceased donor kidneys 2012–2015. Inpatient, outpatient, other facility costs and eGFRs at discharge, 6 and 12 months were included. A time-history of costs was constructed for graft failures and monthly costs in the first year post-transplant were compared to those without failure. The cohort of 24,021 deceased donor recipients had a 2.4% graft failure rate in the first year. Total medical costs exhibit strong trends with eGFR. Recipients with 6-month eGFRs of 30–59 ml/min/1.73m2 have total costs 48% lower than those <30 ml/min/1.73m2. For recipients with graft failure monthly costs begin to rise 3–4 months prior to failure, with incremental costs of over $38,000 during the month of failure. Mean annual total incremental costs of graft failure are over $150,000. Total costs post-transplant are strongly correlated with eGFR. Graft failure in the first year is an expensive, months-long process. Further reductions in early graft failures could yield significant human and economic benefits.