While most healthcare costs for living kidney donors are incurred during the perioperative period, there are also significant costs related to evaluation and follow-up care, reports a study in Transplantation.
The retrospective analysis included 1099 living kidney donors who donated at one Ontario transplant center between 2004 and 2014. All aspects of predonation and postdonation care were covered under Canada’s universal health insurance program. Costs related to the donors’ care were analyzed in three periods: predonation evaluation; perioperative care, including the nephrectomy and 30-day postoperative period; and follow-up to 1 year after donation. Incremental costs, compared to healthy matched donor controls, were expressed in 2017 CAD $.
The estimated healthcare costs for living kidney donors were about CAD $3596 for the evaluation period, CAD $11,694 for the perioperative period, and CAD $1011 for the follow-up period. The costs for evaluation were higher if the recipient started dialysis after the start of the donor evaluation period.
Overall, the costs associated with living kidney donation were higher for women, older donors, and over a longer predonation period. The investigators found that costs were lower in more recent years. They also found significant variation in costs during the perioperative period between transplant centers.
Having accurate estimates of the costs of living kidney donation is essential to encouraging more people to be living kidney donors. Many previous studies of this issue have looked only at the surgical costs of donation, without considering the costs of donor evaluation and follow-up care.
Habbous S, et al. Healthcare costs for the evaluation, surgery, and follow-up care of living kidney donors. Transplantation 2018; 102:1367–1374].