Shortage of donor kidneys taxes health care

British Columbians waiting for transplants cause more expense with dialysis, treatment costs

By Andrea Woo and Carmen Chai, Vancouver Sun; Postmedia News

January 21, 2011

B.C. set a record for organ transplants in 2010, but British Columbians wait longer for kidney transplants than anywhere else in Canada.

And that comes with a huge cost, as people awaiting kidney transplants require hemodialysis at a cost of $60,000 a year per patient. By comparison, the one-time cost of a kidney transplant is about $23,000, plus $6,000 for medication to maintain the transplant.

Based on estimates by the Canadian Institute for Health Information, about $250,000 would be saved over a five-year period for every patient who received a transplant and stopped dialysis treatment.

A news release issued by BC Transplant on Thursday said 295 organ transplants were done last year, up from 211 in 2009, 266 in 2008 and 172 in 2007. Of last year's transplants, 189 were kidney transplants.

The Canadian Institute for Health Information data from 2007 and 2009 showed waiting times for kidney transplants in B.C. were nearly six years. Nova Scotia residents had the shortest waiting time, at just over two years.

Pauline Buck, communications manager for the Kidney Foundation of Canada's B.C. branch, attributed B.C.'s delay to a shortage of organ donors.

"About three or four years ago, BC Transplant did a survey asking British Columbians if they were in favour of being an organ donor, and 85 per cent of the people surveyed said yes. But to date, only 17 per cent of those people have signed up to be organ donors -- so that's the problem."

Buck said many people are not aware that registering to be an organ donor can take as little as two minutes online.

"For those that don't like doing things online, there are organ donation registration forms," she said. "There is a list on BC Transplant's site of where you can get the forms."

A report released by the Canadian Institute for Health Information Thursday said that across Canada, the number of people living with kidney failure has tripled in 20 years and thousands of patients are waiting for kidney transplants.

If everyone on the waiting list got a transplant, about $150 million would be saved each year because of less dialysis treatment expenses, said Claire Marie Fortin, CIHI's manager of clinical registries.

There were nearly 38,000 Canadians living with kidney failure in 2009 -- more than triple the number recorded in 1990 -- with 3,000 people on a transplant waiting list, according to the institute's annual study examining organ failure.

"Dialysis is expensive, there's no denying it. It's also onerous on the patient," said Fortin.

"We always think of dollars and cents when it comes to health care, but there are patients involved and these are people who have to travel far to get their dialysis. A greater supply of organs would be beneficial to the system," Fortin said.

In 2009, more than 15,000 patients living with kidney transplants saved the health care system an estimated $800 million because they stopped dialysis treatments, the study showed.

Dr. Peter Nickerson, a Manitoba-based transplant nephrologist and medical director for transplantation at Canadian Blood Services, said he's compared dialysis expenses with transplant costs while managing the province's transplant program. "Those numbers and that gap in price is exactly right," he said, calling the difference in costs "concerning."

The need for kidneys eclipses the demand for other organs, such as the heart, liver, lungs and pancreas.

Copyright (© The Vancouver Sun.

This article posted February 7, 2011.