All solid organ transplantation (with the exception of liver transplantation for alcoholic liver disease) is cost-effective, particularly in relation to NHS spend.1(UK)
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.2
There are 37,500 patients with end-stage renal failure in the UK. 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.3
The average cost of dialysis is £30,000 per patient per year.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.2
The immunosuppression required by a patient with a transplant costs £6,500 per patient per year.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)5 is £191,000 or £21,200 per year for each year that the patient has a functioning transplanted kidney.
In 2002-03, 1,775 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.6
In 2002-03, 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.6
In 2002-03 UK Transplant recorded 17,110 people in the United Kingdom with a functioning kidney transplant.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 2002-03 UK Transplant provided support for 5,077 transplants (2,780 solid organ transplants and 2,297 cornea transplants).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.
References and notes
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 behalf of CELT. Department of Health Report 2001.
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
3 UK Renal Registry, November 2003
4 A weighted average of the cost of dialysis based on 70% of patients receiving haemodialysis.
5 UK Transplant, Based on cadaveric kidney-only first graft recipients of transplants carried out in 1990-1992.
6 UK Transplant, Activity Report 2002-2003
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.
You can find out more about joining the NHS ODR by ringing 0845 60 60 400 or visiting our website http://www.uktransplant.org.uk
