The American Society of Transplantation would like to call your attention to the need for clear metrics on Dialysis Centers referral to evaluation for transplant.
Why is this a problem?
There is concern that people with end stage kidney disease (ESKD) who are receiving dialysis may not be receiving adequate information about kidney transplantation or referrals to transplant hospitals for transplant evaluation.
A Way to Prolong and Improve Quality of Life for Reduced Cost
While mortality rates have fallen for all people with ESKD1, the deaths after transplant are still far lower than with dialysis:
- Kidney transplantation is associated with lower hospitalization rates, improved quality of life, and better chance of joining the work force and starting a family. The vast majority of patients with ESKD on dialysis would benefit from transplantation versus ongoing dialysis.
- The cost of maintaining a person on dialysis is nearly three times as much per year, as maintaining a healthy kidney transplant.
For these reasons, increasing transplant rates and ensuring long-term success of transplanted kidneys is critical to improving the lives of people with ESKD and managing associated costs.
Why Aren’t More Kidneys Being Transplanted?
People with ESKD face several significant hurdles on their path to successful kidney transplantation.
- Timely referral of potential transplant candidates for evaluation and listing for a kidney transplant is critical in order provide maximum access to transplantation before these patients become too sick to be transplanted.
- Once listed for a transplant, these kidney transplant candidates face an acute shortage of donor organs. This may mean long waits, all the while on dialysis, with increased risk of death and increased cost. Effective and efficient patient referral, education, and listing practices combined with improvements of the organ donor pool through living donor education, clear OPO metrics for deceased donor organ referral and recovery and decreased deceased donor organ discard rates will help to address the wait for organ transplantation.
How Can We Solve This Problem?
Support the development of dialysis center metrics to measure the level of patient education and quality of the referral process.
Approved by the AST Executive Committee on April 4, 2017
Revised and approved by the AST Board of Directors on March 3, 2020
1 United States Renal Data System (USRDS) 2018 Annual Data Report
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