*Purpose: We aimed to study the health economic effects of kidney transplantation in a population of kidney transplant candidates > 65 years of age.

*Methods: We performed a prospective single center study comparing costs, quality adjusted life years (QALYs) and self-perceived health during the last year before and the first year after kidney transplantation in 289 patients ≥ 65 years at enlisting. The patients completed an SF-36 survey every six months at waiting list, and at two, six and twelve months post-transplant. A health index was derived for each patient at each visit as a measure of self-perceived health. QALYs were computed based on individual health indexes and survival data from the same cohort. Average costs of continued dialysis compared to immunosuppression/follow-ups after engraftment were imported.

*Results: At time of data retrieval, 205 patients had received a transplant, 29 of them (14%) from a living donor. Median age at transplantation was 71.6 (65.0-83.6) years. Both Self-perceived health (Figure 1) and QALYs (Table 1) improved significantly after transplantation. At one year, the costs/QALY were substantially higher for transplantation (101 000 $ vs. 88 000 $). Preliminary analyses including 3-year post transplant data from 64 patients do however suggest that this is reversed completely already after two years.

*Conclusions: We conclude that compared to remaining on the waiting list, kidney transplantation is associated with improved health but also with increased costs the first year after transplantation. Preliminary analyses clearly suggest a positive long-term cost-effectiveness, but this needs to be confirmed.

« Back to 2019 American Transplant Congress