Resource use and treatment costs after kidney transplantation: Impact of demographic factors, comorbidities, and complications

Erst Günther Hagenmeyer, Bertram Häussler, Elke Hempel, Gerrit Grannas, Zoltán Kaló, Anne Kilburg, Björn Nashan

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background. Our goal was to quantify outcomes, resource use, and treatment costs for the first 2 years after renal transplantation in a "real-life" European setting and to assess the impact of preoperative risk factors and postoperative complications on treatment costs. Methods. Inpatient and outpatient records of all patients who received a renal transplant at Medizinische Hochschule Hannover, Germany, between January 1998 and July 2000, were evaluated. Key clinical events were recorded. Direct costs were calculated for primary hospitalization, the remainder of year 1, and year 2 after transplantation. Cost of organ procurement, pretransplant care, and transplant surgery were excluded. Cost consequences for key clinical events were determined. Results. Of 204 patients undergoing transplantation, 195 and 149 completed 1 year and 2 years of follow-up, respectively. The outcomes of years 1 and 2, respectively, were as follows: graft failure, 5.4%, 0.7%; acute rejection, 35.9%, 5.4%; cytomegalovirus (CMV) infection, 29.2%, 2.0%; and delayed graft friction, 30.9%. Costs for primary hospitalization, the remainder of year 1, and year 2 averaged ε15,380, ε18,636, and ε14,484, respectively. Cost-driving events included graft failure ε36,228), acute rejection (ε9,638),delayed graft function (ε7,359), and CMV infection (ε4,149). Graft failure and acute rejection for year 1 also added significantly to the costs for year 2. Conclusions. These results show that posttransplant clinical outcomes result in a significant increase in treatment costs. Because the economic impact of primary causes of chronic rejection (acute rejection and CMV) and delayed graft function is substantial, careful selection of the most appropriate immunosuppressive regimen is essential.

Original languageEnglish
Pages (from-to)1545-1550
Number of pages6
JournalTransplantation
Volume77
Issue number10
DOIs
Publication statusPublished - May 27 2004

ASJC Scopus subject areas

  • Transplantation

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