NKF Campaigns Zone:
Transplantation & Live Donors

[The following Press Release, Number 287/03 was issued by UK TRANSPLANT on 7 December 2003]

FACT SHEET
TRANSPLANTATION COST EFFECTIVENESS

• All solid organ transplantation (with the exception of liver transplantation for alcoholic liver disease) is cost-effective, particularly in relation to NHS spend.^{Ref 1}
• Kidney transplantation is very cost-effective and is the treatment of choice for those with end-stage renal failure.
• Maintaining a patient with end-stage renal failure on renal replacement therapy (dialysis) costs £20,000 per patient per year for a patient on peritoneal dialysis and £34,500 per patient per year for a patient on haemodialysis.^{Ref 2}
• There are 37,500 patients with end-stage renal failure. Over 20,000 are on dialysis, whilst the remainder have a transplant. Of those on dialysis, 70% are on haemodialysis and 30% on peritoneal dialysis.^{Ref 3}
• The average cost of dialysis is £30,000 per patient per year.^{Ref 4}
• 3% of the NHS budget is spent on kidney failure services.
• The cost of a kidney transplant (excluding UK transplant costs) is £20,000 per patient per transplant.^{Ref 2}
• The immunosuppression required by a patient with a transplant costs £6,500 per patient per year.^{Ref 2}
• Kidney transplantation leads to a cost benefit in the first year of £3,500 and £23,500 in subsequent years.
• The cost benefit of kidney transplantation compared to dialysis over a period of nine years (the median graft survival time) ^{Ref 5} is £191,000 or £21,200 per year for each year that the patient has a functioning transplanted kidney.
• In 2002-3, 1775 people benefited from a kidney transplant. These transplants are now saving the NHS £37.6m in dialysis costs each year for every year that the kidney functions.^{Ref 6}
• In 2002-3, as a result of increased investment in organ donation initiatives, 75 more kidney transplants were provided than in the previous year. These transplants are now saving the NHS £1.6m every year until graft failure.^{Ref 6}
• In 2002-3 UK Transplant recorded 17,110 people in the United Kingdom with a functioning kidney transplant.^{Ref 7} In this year, these patients will save the NHS £363m in the dialysis costs that they would need if they did not have a functioning kidney transplant.
• In 2002-3 UK Transplant provided support for 5,077 transplants (2,780 solid organ transplants and 2,297 cornea transplants).^{Ref 6} In the same year, UK Transplant’s net operating cost was £8m. The UK Transplant cost of a single transplant was £1,575 and includes promoting organ donation, matching and allocating donor organs, collecting clinical follow-up data on all transplanted patients until death or graft failure and providing a programme of clinical audit and analysis.

December 2003

References and Notes

Ref 1 - ‘An economic evaluation of lung transplantation’. A Anyanwu, A McGuire, C Rogers and A Murday, The Journal of Thoracic and Cardiovascular Surgery, Volume 123, number 3, March 2002 pp411-420.

‘Economic evaluation of end stage renal disease treatment’. G Ardine de Wit, P Ramsteijn and F de Charro, Health Policy 44, 1998, pp215-232.

‘Economic Evaluation of the Liver Transplant Programme in England and Wales: An assessment of the cost-effectiveness of liver transplantation for three liver disease groups’. L Longworth, T Young, J Radcliffe on hehalf of CELT. Department of Health Report 2001.

Ref 2 - Costs given in: P Roderick, R Davies and C Jones, (2002) Predicting the future demand for renal replacement therapy in England, BRS Workforce Planning Group

Ref 3 - UK Renal Registry, November 2003

Ref 4 - A weighted average of the cost of dialysis  based on 70% of patients receiving haemodialysis.

Ref 5 - UK Transplant, Based on cadaveric kidney only first graft recipients of transplants carried out in 1990 - 1992.

Ref 6 - UK Transplant, Activity Report 2002-2003

Ref 7 - UK Transplant, Based on number of patients in the UK with a functioning kidney transplant, who have not been lost to follow-up or have died, and whose last assessment date was after January 2002.