This study examines the impact of dialysis during the transplant admission on total cost of transplant and one year post-transplant care for kidney, liver, and heart recipients.

Methods: Clinical and financial data were extracted from a large commercial health plan claims database for adult patients who received a kidney, liver or heart transplant from January 2010 through September 2015. The total cost of care included costs during the transplant admission plus one year following discharge. Dialysis during the transplant admission was identified via claims data. Generalized linear mixed models were used to estimate cost controlling for recipient, donor, and center characteristics.

Results: A total of 1,979 kidney transplant recipients, 1,234 liver transplant recipients, and 417 heart transplant recipients were included in the study. The study sample size decreased in the post-transplant cost analysis due to recipient no longer enrolled in health plan. Receiving dialysis during their transplant admission significantly increased total health care cost by $51,241 for kidney transplant recipients, $265,042 for liver transplant recipients and $396,659 for heart transplant recipients during their transplant admission stay. Post-transplant costs increased significantly for liver and heart transplant recipients who received dialysis during their transplant admission, $77,042, $311,381, respectively. Receipt of dialysis during the transplant admission did not significantly impact post-transplant costs in kidney transplant recipients.

Conclusion:The study shows that dialysis during the transplant admission is a significant cost driver of medical cost in both the transplant admission as well as the one year following discharge.

CITATION INFORMATION: Tao J, Horstman C, Bannister W, Schnitzler M, Irwin F, Bonagura A, Laihinen B. Impact of Dialysis During the Transplant Admission on Transplant and Post-Transplant Cost of Care. Am J Transplant. 2017;17 (suppl 3).

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