Kidney transplants could save health-care system millions: Report

Kidney transplants could save health-care system millions: Report

BY CARMEN CHAI, POSTMEDIA NEWS JANUARY 20, 2011 COMMENTS (9)

The number of Canadians living with kidney failure has tripled in 20 years and thousands of patients are waiting for kidney transplants, researchers say in a report that suggests that if transplants were available, $150 million spent on expensive treatments would be saved.
Photograph by: Kambou Sia, AFP/Getty Images
The number of Canadians living with kidney failure has tripled in 20 years and thousands of patients are waiting for kidney transplants, researchers say in a report that suggests that if transplants were available, $150 million spent on expensive treatments would be saved.

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 an annual study examining organ failure released Thursday by the Canadian Institute for Health Information (CIHI).

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

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

Hemodialysis treatments cost $60,000 a year per patient while a one-time expense for a kidney transplant is only about $23,000, plus an additional $6,000 for medication to maintain the transplant, Fortin said.

Based on CIHI's estimates, about $250,000 would be saved over a five-year period if one patient received a transplant and stopped dialysis treatment.

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."

Diabetes, heart disease and hypertension have been linked in Canada to kidney failure. Diabetes is the predominant cause of kidney failure as one in three kidney failure patients is diabetic, the report showed.

It found that the highest rates of kidney failure were found in Newfoundland and Manitoba, while the lowest rates were in Quebec and Alberta.

"As a society, we know (these diseases) are increasing problems, so we expect to see kidney failure to be a growing problem as diabetes rates climb. Our wait lists for transplants will continue to be significant unless our donation numbers go up," Nickerson said.

As kidney failure increases in Canada, transplants have not kept up with the demand, the report showed. The need for kidneys eclipses the demand for other organs, such as the heart, liver, lungs and pancreas. In total, there are only 1,000 patients waiting for these organs, he said.

With about 14 kidney donors per million people, Canada is lagging behind other countries, such as the United States, Spain, Italy and Belgium, the study said.

In the U.S., there are about 26 to 28 donors per million people and in Spain, there are more than 30, Nickerson said.

Between 2000 and 2009, 10,641 kidney transplant procedures were performed in Canada, the report showed. Ontario led the country with the most living donor transplants, followed by British Columbia.

But wait times for kidneys were the longest in B.C., at nearly six years, according to data from 2007 to 2009. Nova Scotia residents had the shortest wait time, at just over two years.

The researchers looked at records from the Canadian Organ Registry's database and also gathered information from hospitals, dialysis facilities, transplant centres and organ procurement organizations, Fortin said.

The $60,000 annual price tag for hemodialysis, a procedure that cleans the blood, is based on an average of three weekly visits and does not include physician fees or procedures that take place outside the hospital.

Fortin said she hopes the findings will help raise awareness of the need for kidney transplants as waiting lists continue to grow.

The researchers say transplants would be more cost-efficient and provide kidney failure patients with a longer life and less time at the hospital.

Dialysis treatments take between four and eight hours a day and usually need to be performed three times a week, said Dr. Louise Moist, a nephrologist and president of the Canadian Organ Replacement Registry.

"Dialysis comes with a burden. It is time-consuming. . . . People on transplant lists are waiting for a way out of that system so they can get their lives back," she said, noting that many patients eligible for a transplant carry pagers in case a compatible donor becomes available.

"There's always hope and some anxiety and perhaps even some disappointment when the end of the day comes and they haven't been called," Moist said.

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