Date: Tuesday, June 4, 2019
Session Name: Poster Session D: Non-Organ Specific: Economics & Ethics
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: To compare and evaluate outcomes of for younger (Y) versus elderly (E) kidney transplant recipients (KTR) during the first year post-transplant. As the number of elderly KTR increases, differences between this population and younger are unknown.
*Methods: A single-center retrospective analysis of medical records of 318 first-time KTR from 2003-10 on mycophenolate, tacrolimus, and steroid regimen was performed. The study population was divided into two cohorts: (Y: ≤59 yrs; n=172; E: ≥65 yrs; n=146). KTR aged 60-64 were excluded to distinguish groups. Baseline characteristics, the number of readmissions post-transplant (RA), readmission lengths of stay (LOS), and the total follow-up costs of the first year post-transplant were analyzed. Reliability was tested using the Wilcoxon rank-sum test for the median comparisons between elderly and younger subjects’ number of readmissions, readmission lengths of stay, and follow-up costs during the first year post-transplant. The chi-square test was used to test significance when readmission during the first year was tested as a binary variable (yes vs no).
*Results: Younger and elderly KTR had similar numbers of RA and LOS; however, elderly follow-up costs were significantly more than younger subjects.
|Table 1||Younger||n = 172||Elderly||n = 146||Y vs E, p-value|
|Transplant Hospitalization LOS, days||5 (4, 7)||172||5 (5, 7)||146||NS|
|Follow-up costs at 1 year, $||185955 (144344, 264409.25)||172||212397 (166613.25, 274234.25)||146||<0.01|
|eGFR at 1 year, median mL/min/1.73m2||46.47 (34.96, 60.1)||172||49.19 (37.47, 64.85)||146||NS|
|Number of readmissions per patient, median||1 (0, 2)||172||1 (0, 2)||146||NS|
|Readmission lengths of stay, median days||1 (0, 10)||172||3 (0, 10.75)||146||NS|
|Readmission rate, (%)||89 (51.7)||172||86 (58.9)||146||NS|
*Conclusions: Elderly KTR appear to present a greater economic burden on hospital systems during the first year post-transplant due to the greater costs of care; however, with similar post-transplant rates of RA and LOS, the costs incurred may be related to comorbid health conditions rather than transplant-related follow-up. A more detailed analysis of the reasons for expensive hospitalizations post-transplant may be beneficial in determining the risk-benefit of transplanting elderly patients.
To cite this abstract in AMA style:Yaldo A, Bajjoka I, Crombez C, Abouljoud M. A Financial Analysis of Elderly Kidney Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/a-financial-analysis-of-elderly-kidney-transplant-recipients/. Accessed September 17, 2019.
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