An examination of the renal transplant evaluation process focusing on cost and the reasons for patient exclusion.
A medical evaluation of prospective renal transplant recipients is performed to identify conditions that may exclude patients from transplantation because of unacceptable risks.
Protocols for evaluating potential transplant candidates are available, but there is little information about reasons for excluding patients from transplantation.
To assess the effectiveness and cost of our renal transplant-recipient evaluation process, we retrospectively reviewed patients excluded from renal transplantation between January 1993 and December 1995 to categorize the reasons for exclusion.
We also examined the costs of the evaluation.
The study group included all adults referred for kidney-only transplantation during the study period who were excluded from transplantation (n=125).
Demographics of the 160 patients with end-stage renal disease (ESRD) who underwent renal transplantation during the study period were also examined.
Compared with the patients who underwent transplantation, the excluded patients were older (48 ± 14 v43 ±12 years ; P=0.006) and more likely to be women (66 of 125 patients ; 53% v57 of 160 patients ; 36% ; P=0.005) and diabetic (59 of 125 patients ; 47% v 30 of 160 patients ; 19% ; P=0.005).
The most common reason for excluding patients was medical contraindication (46%), followed by patient declined (25%), obesity (10%, defined as a body mass index [BMI] = 35), patient death (6%), and insurance/financial (5%). (...)
Mots-clés Pascal : Transplantation, Rein, Evaluation, Critère décision, Risque, Echec, Age, Sexe, Association morbide, Coût, Etude statistique, Homme, Chirurgie, Appareil urinaire pathologie, Rein pathologie, Economie santé
Mots-clés Pascal anglais : Transplantation, Kidney, Evaluation, Decision criterion, Risk, Failure, Age, Sex, Concomitant disease, Costs, Statistical study, Human, Surgery, Urinary system disease, Kidney disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0505363
Code Inist : 002B25H. Création : 19/02/1999.