The cost of procuring deceased donor kidneys: Evidence from OPO cost reports 2013-2017

Abstract

Using 5 years of US organ procurement organization (OPO) data, we determined the cost of recovering a viable (ie, transplanted) kidney for each of 51 OPOs. We also examined the effects on OPO costs of the recovery of nonviable (ie, discarded) kidneys and other OPO metrics. Annual cost reports from 51 independent OPOs were used to determine the cost per recovered kidney for each OPO. A quadratic regression model was employed to estimate the relationship between the cost of kidneys and the number of viable kidneys recovered, as well as other OPO performance indicators. The cost of transplanted kidneys at individual OPOs ranged widely from $24 000 to $56 000, and the average was $36 000. The cost of a viable kidney tended to decline with the number of kidneys procured up to 549 kidneys per year and then increase. Of the total 81 401 kidneys recovered, 66 454 were viable and 14 947 (18.4%) were nonviable. The costs of kidneys varied widely over the OPOs studied, and costs were a function of the recovered number of viable and nonviable organs, local cost levels, donation after cardiac death, year, and Standardized Donor Rate Ratio. Cost increases were 3% per year.

Pig kidney xenotransplantation: Progress toward clinical trials

“…If the immunosuppressive therapy required is comparable (which is not yet certain), then the only major difference in costs may be the acquisition of the kidney. In the USA, the costs associated with retrieval of a single deceased human kidney are considerable, 56,57 and generally vary from approximately $25 000 to $40 000 (mean $33 000), but can be much greater, and are passed on to the recipient. When genetically engineered pig organs become commercially available, it could well be that a pig kidney will be priced significantly higher than this, in part to defray the very considerable research and development expenditure that has been incurred during the past 20‐30 years 58 .…”

“…For example, there are patients of blood group B or even O who may remain on the wait-list for 7 or more years in our region. If the patient is aged[55][56][57][58][59][60] or older at the time he/she is placed on the list, there is a realistic possibility that he/she will either have died or, because of the development of comorbidities, become an unacceptable candidate for a kidney transplant during that period of time.…”

Potential donor characteristics and decisions made by organ procurement organization staff: Results of a discrete choice experiment

“…OPO revenue and financial performance could help explain this preference. Standard organ acquisition costs vary significantly by OPO, 29 and costs for both HIV‐positive and HIV‐negative organs are fully reimbursed by Centers for Medicare and Medicaid Services, suggesting that organ recovery costs are likely not a major driver of preference for HIV‐negative donors. Additionally, tissue for allografts cannot currently be recovered from HIV‐positive donors.…”

The Future of Clinical Islet Transplantation in the United States

“…It can be difficult to estimate the costs associated with islet Tx since funding in the US is covered under clinical trials; (i), a fair market value for services does not exist, (ii) the cost of organ procurement can vary regionally and by organ procurement organization (OPO) [76]; (iii), fees for islet isolation and the use of GMP facilities vary by center; and (iv), multiple organs may be needed to achieve a therapeutic goal [16,55]. International reports placed the cost at about $70,000 per infusion in Canada (about $54,000 US dollars) [77] and less in France [78].…”