Monday, June 7, 2021

Help for Danish kidney-exchange pairs, from a private foundation (while waiting for the health care system to cover international exchange)

 Yesterday I blogged about a particular global kidney exchange in which a Danish pair joined an American kidney exchange chain. Among the obstacles to be overcome were some of a financial nature: the Danish healthcare system declined to pay for a transplant outside of Denmark, even though no compatible kidney had been found in Denmark after several years of waiting.

The first part of the good news is that both the patient and donor are thriving, back home in Denmark.  The second part of the good news is that a private Danish foundation has stepped forward to help bridge some of the financial obstacles.

Mike Rees writes to me as follows:

"A Go Fund Me-type campaign in Denmark was initiated by a Newspaper advertisement placed by Claus Walther Jensen. Many small donations later, and a large donation from a wealthy businessman, Niels Due Jensen, himself a kidney transplant recipient, helped pay for Natacha’s transplant and associated expenses to come to the US. The APKD subsidized about $40,000 of their costs—including the donor’s lost wages, travel expenses, etc. After seeing the success, Niels Due Jensen established a fund with 5M Kroner per year for five years to support GKE for Danish citizens who cannot match in Scandinavia. See: ." 

The page opens with the story that was the subject of yesterday's blog:

"13 people died in 2019 on the waiting list for a new kidney in Denmark. In addition, 47 people were permanently removed from the waiting list because they had become too ill to receive a new kidney.

"This is because we in Denmark and Scandinavia have a fundamental shortage of donor kidneys. 
Natacha is one of the patients who should still have been on the waiting list if it was up to the Danish healthcare system. In the United States, a matching kidney was found in less than 2 hours."
The site goes on to tell the larger story:
"Do we have a well-functioning kidney exchange system in Denmark?
"In Denmark, we are not skilled enough to optimize the supply of donor kidneys, which is partly due to the fact that we do not utilize the full potential of close friends and family who want to donate a kidney to their loved ones. This is because a donor kidney must "match" the recipient's tissue type and blood type in order for the recipient to benefit from the donor kidney.

"There will on average be a match for approx. 70% of cases, which means that in 30% of cases the donor does not have the opportunity to donate, which is a big waste - which can be partially avoided!

"For almost 20 years, so-called "kidney exchange systems" have existed abroad, which allow non-matching donors to indirectly help their loved ones, by donating to a pool (and thus to another person) so that one's loved ones in return receive a matching donor kidney from the same pool. With this, there are 2 or more "pairs" who exchange donor kidneys, so that all patients get a kidney that suits them.

"In Scandinavia, a "kidney exchange system" has now also been made, which is a major step forward. However, the system is not as efficient as in the USA, for example, where the pools of donor kidneys are much larger and thus also much more efficient. The system in the USA can therefore help those patients who cannot be helped via the Scandinavian system.

"So far, the Regions and doctors have chosen not to inform the Danish kidney patients about this possibility. In addition, Region H has in two cases refused to pay for Danish kidney patients who have been part of the kidney exchange system in the USA to have a transplant performed in the USA. The cost is approx. DKK 800,000 pr. person. The two patients have had the transplants completed in the USA by self-payment and collection from benevolent Danes, respectively. Both patients are well-functioning today and make a positive contribution to Danish society."
And, to get to the point:
"Niels Due Jensen's non-profit foundation works to ensure that the Danish hospital system offers Danish kidney patients, approved for kidney transplantation in Denmark, who have a non-matching donor kidney, also approved for transplantation in Denmark, that they can be offered to join a foreign kidney exchange system and that the state will bear the costs associated with a transplant abroad. Of course, provided that the patient in question does not receive or is expected to be able to receive a donor kidney in Denmark within a reasonable time (one year).

"Until the Danish kidney patients get this right, Niels Due Jensen's non-profit foundation will donate up to 5 million every year DKK, to support people residing in Denmark who, based on an overall assessment of their own financial resources and health condition, have an urgent need for costly treatment for kidney transplantation, and possibly, for a transitional period, support the individual patient's convalescence."

I salute Mr. Jensen, and I look forward to the day when global kidney exchange will be a standard part of medical care to address the global problem of kidney failure.

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