Cost–Benefit Estimation of Cadaveric Kidney Transplantation: The Case of a Developing Country

Domı́nguez, J.; Harrison, Rodrigo; Atal, R.

doi:10.1016/j.transproceed.2011.06.006

Cited by 23 publications

(25 citation statements)

References 14 publications

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“…1, 2, 3, 4 This is especially the case for sub-Saharan Africa, where maintenance dialysis is beyond the reach of most of the population.…”

Section: Introductionmentioning

confidence: 99%

“…KT is recognized globally as the gold standard treatment modality for ESRD patients because of its overall cost effectiveness, guaranteeing of an almost normal quality of life, as it affects different domains and reduced frequency of hospital visits and hospitalizations. 1, 2, 3, 4, 13 It however has its constraints, which include the huge financial outlay at the outset, shortage of donor organs, challenges of immunosuppression and, very recently, organ trafficking 13, 21, 22, 23, 24, 25, 26, 27, 28 , This current review is aimed at assessing kidney transplant activities in Nigeria from the years 2000–2010 with the objective of highlighting the outcomes and challenges. This is to be able to proffer ethically and culturally acceptable solutions to the identified challenges without compromising standards.…”

Section: Introductionmentioning

confidence: 99%

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Kidney transplantation in a low-resource setting: Nigeria experience

Arogundade

2013

Kidney International Supplements

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The incidence and prevalence of chronic kidney disease and end-stage renal disease (ESRD) have continued to increase exponentially all over the world in both developed and developing countries. While the majority of patients in developed countries benefit from various modalities of renal replacement therapies, those from developing economies suffer untimely deaths from uremia and cardiovascular disease. Kidney transplantation (KT) leads to improvement in both the quantity and quality of life. Unfortunately, it is not exploited to its full potential in most countries and this is particularly the case in developing economies. Only a very small fraction of the ESRD population in emerging countries ever gets transplanted because of the many constraints. This review focuses on KT in Nigeria between 2000 and 2010 and assessed particular challenges that need be addressed for KT potential to be fully harnessed in such resource-constrained settings. A total of 143 KTs were performed in 5 transplant centers, some of which have only recently opened. One-year graft and patient survival was 83.2% and 90.2%, respectively, while the 5-year graft and patient survival was 58.7% and 73.4%, respectively. Mortality was reported in 38 (27%) of recipients. The complications recorded included acute rejection episodes in 15–30%, chronic allograft nephropathy in 21(14.7%) and malignancies, particularly Kaposi Sarcoma, which was reported in 8 (5.6%) recipients. It was concluded that KT has led to an improved survival but is bedevilled with unaffordability, inaccessibility, a shortage of donor organs and poor legislative support. Enactment of relevant organ transplant legislation, subsidization of renal care, and further development of local capacities would improve KT utilization and thus lead to better outcomes.

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“…1, 2, 3, 4 This is especially the case for sub-Saharan Africa, where maintenance dialysis is beyond the reach of most of the population.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kidney transplantation in a low-resource setting: Nigeria experience

Arogundade

2013

Kidney International Supplements

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“…The study found that the expected present value of costs associated with dialysis is approximatelyUS$134,000, whereas the expected costs of a transplant amount to nearly US$106,000. Overall, the study concluded that cost savings associated with cadaveric kidney donation are positive and substantial, thus cadaveric kidney transplantation is highly encouraged as a primary strategy of renal replacement therapy [11].…”

Section: Comparative Cost-effectiveness Of Esrd Treatment Optionsmentioning

confidence: 98%

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

Tataradze¹,

Managadze²,

Beglarashvili³

et al. 2016

IJCM

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End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems mainly due to substantial treatment-associated costs. The chronic nature of the disease needs expensive continuous care that majority of the patients cannot afford. Therefore, in many countries expenses associated with the ESRD treatment is paid by state government. These treatment options include: hemodialysis, peritoneal dialysis and kidney transplantation. Multiple studies have been conducted throughout the world to assess cost-effectiveness of these treatment modalities. The studies suggest that kidney transplantation not only reduces mortality and morbidity but improves a quality of life of ESRD patients. Furthermore, it is the most cost-effective treatment for the ESRD at least in high-income countries. The goal of our study was to determine whether above-mentioned is true for lower middle income countries, where the cost of the ESRD treatment is substantially lower. Despite the low dialysis costs, transplantation remains the cheapest form of renal replacement therapy RRT in lower income countries like Georgia. Our results reveal, that kidney transplantation is most expensive modality of Renal Replacement Therapy (RRT) at month 1, but count of costs reveals that after the 10 th month of treatment, the cumulative cost of transplantation is less than the cumulative cost of peritoneal dialysis and after the 23 rd month, cumulative cost of hemodialysis also surpasses the cumulative cost of transplantationrelated treatment and this cost comparison is in line with global data from upper-middle and high income countries. A. Tataradze et al. 438

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“…Señor Editor, El trasplante de órganos sólidos es una herramienta terapéutica consolidada, que entrega demostrados beneficios en supervivencia y costo-efectividad para los pacientes 1 , siendo en occidente los donantes cadavéricos en muerte cerebral la principal fuente de injertos 2 . Un fenómeno presente en todo el mundo es la brecha entre la necesidad de órganos y su real disponibilidad, incluso en aquellos sistemas de procuramiento más exitosos en la detección de donantes 2 .…”

Section: Organ Transplantation In Chileunclassified