ABO-Incompatible Kidney Transplants: Twice as Expensive, Half as Good.

Abstract

The authors estimated Medicare spending for all covered services for 270 ABO-incompatible (ABOi) and 27 000 ABO-compatible (ABOc) transplants for the period 30 days before transplant through 3 years after transplant and found that costs for ABOi transplants were 74% higher than those for ABOc transplants. The authors also estimated adjusted hazard ratios (AHRs) for both graft failure and all-cause mortality using a Cox proportional hazards model, controlling for >20 measurements of recipient and donor characteristics. The Cox results showed that ABOitransplanted patients had 1.9 times the risk of both death and graft failure compared with ABOc patients. These estimates indicate that ABOi transplantation costs more and has a large negative impact on the health of recipients compared, with ABOc transplantation.