Tuesday, January 25, 2011

Kidney transplantation in Canada

A new report, Treatment of End-Stage Organ Failure in Canada; 2000 to 2009 draws on data from CIHI's Canadian Organ Replacement Register (CORR). (The report can be accessed directly here.) A news report focusing on kidney transplantation is here: Kidney transplants can save millions in dialysis costs: organ transplant report.

From the news summary:
"The number of people living with kidney failure more than tripled in Canada in the last 20 years, new statistics show, but experts hope to save lives and millions of dollars in dialysis costs by expanding organ donor programs.

"A report released Thursday by the Canadian Institute for Health Information shows that at the end of 2009, there were 37,744 people being treated for end-stage renal disease, with 59 per cent of them on dialysis and 41 per cent living with a functioning kidney transplant.

"Kidney failure rates appear to be stabilizing, but the supply of organs available for transplant has not kept pace with growing demand.
About 3,000 people were on waiting lists for a transplant in 2009. If they all received a transplant, it could result in annual savings of $150 million, the institute estimated.
"As for transplants, Nickerson said deceased donation tends to be better than average in Quebec and Atlantic Canada, at between 16 and 19 donors per million population.

"If you look at the U.S., the average donation rate is around 26 to 28 donors per million; if you look at Spain, it's up in the 30 donors per million range," Nickerson said.
"Donation rates can be significantly higher than what they are currently in Canada. And we've been stuck at this sort of 14 to 15 national average for a number of years now."
"CIHI estimated the annual cost of hemodialysis treatment at $60,000 per patient, compared to a one-time cost of $23,000 for a transplant plus $6,000 per year for medication.

Nickerson said savings are about $250,000 over five years.

"Sixteen to 20 years is the average expectancy of a living donor kidney transplant," he said, adding that deceased donor transplants would probably last 10 to 12 years.
Between 2000 and 2009, there were 10,641 kidney transplant procedures registered in the Canadian Organ Replacement Registry. Of these, 11 per cent were re-transplants. Of the 9,430 kidney-only first transplants, 61 per cent used deceased donor kidneys.
Since 2006, the number of living donor kidney transplants has been stable, fluctuating between 440 and 461 transplants per year.
"Canadian Blood Services recently launched a paired kidney exchange registry, which allows pairs to receive and donate a kidney from among other registered pairs even if they're not matches for each other.

Nickerson said 185 pairs are registered, and 65 kidney transplants have been done that otherwise wouldn't have occurred.
"And we know that this is only the beginning," he said.

"We estimate that we should have on an annual basis another 200 to 250 pairs joining annually and that we can facilitate about half of them finding transplants on a yearly basis."

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