Editorial: ABO Incompatible Kidney Transplants: Twice as Expensive, Half as Good

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13638/abstract?campaign=wolacceptedarticle

Editorial


ABO Incompatible Kidney Transplants: Twice as Expensive, Half as Good
Philip J. Held and Frank McCormick
American Journal of Transplantation
DOI: 10.1111/ajt.13638

Abstract
The authors estimated Medicare spending for all covered services for 270 ABO incompatible (ABOi) and 27,000 compatible (ABOc) transplants for the period 30 days pre-transplant through 3 years post-transplant and found incremental costs for ABOi transplants were 74 percent higher than for ABOc transplants. The authors also estimated adjusted hazards ratios (AHR) for both (a) graft failure and (b) all-cause mortality using a Cox proportional hazards model, controlling for over 20 measurements of recipient and donor characteristics. The Cox results showed ABOi transplanted patients had 1.9 times the risk of both death and graft failure compared to ABOc patients. These estimates indicate ABOi transplantation (a) cost more, and (b) has a large negative impact on the health of recipients (compared to ABOc transplantation).

[donor99]

With the kidney paired exchange and the priority on the UNOS wait-list for sensitized patients...there is really no reason to do any ABO incompatible transplant.