A pilot project led by The University of Toledo that could increase the number of kidneys available for transplant by the thousands and save U.S. taxpayers millions if implemented nationwide has been funded by the U.S. Agency for Healthcare Research and Quality.“Many tests need to be conducted to ensure that a kidney donor and recipient are compatible and that it is safe for the donor to donate,” said Dr. Michael Rees, University of Toledo Medical Center transplant surgeon and principal investigator of the four-year, $2 million grant. “One of the primary barriers to greater kidney availability is that once an insurance company or Medicare learns that donor A’s kidney isn’t compatible with recipient A, they stop funding the tests and no transplant occurs.
“This grant will enable us to create an entity that pays to complete donor A’s tests, which allows us to discover that recipient B in another part of the country is compatible,” Rees said. “Once donor A gives to recipient B, the insurance company for recipient B will reimburse the entity for the cost of donor A’s tests. In a similar way, it may be donor K or donor W who ultimately ends up being compatible with recipient A.”
Rees estimated that if such a model was expanded nationwide, as many as 1,000 to 3,000 additional kidney transplants would be possible each year.
“The savings to Medicare and insurance companies could reach into the hundreds of millions of dollars due to the elimination of regular treatments like dialysis and other medical efforts for those waiting for an organ,” Rees said.
To execute the pilot project, UT will partner with the Southwest Transplant Alliance and the Alliance for Paired Donation, an organization founded by Rees to help incompatible kidney donors and recipients find alternative compatible matches. The Alliance for Paired Donation is northwest Ohio-based not-for-profit entity that has partnered with more than 80 transplant centers across America to find matches for patients.
“The University of Toledo is proud to lead the way as we explore a truly innovative approach to improving the quality of life and saving the lives of those waiting for a kidney transplant,” said Dr. Jeffrey P. Gold, chancellor and executive vice president of biosciences and health affairs, and dean of the College of Medicine and Life Sciences. “We fully expect that as more matches are made between donors and recipients, this project will become self-sustaining and will serve as a model for hospitals, insurance companies and the federal government to improve health care and reduces costs.”
Gold and Rees thanked U.S. Ohio Sen. Rob Portman as well as Congresswoman Marcy Kaptur for their help in advocating for the value of the grant to those in need of kidney transplants.
“This innovative program will make sure that these volunteers’ honorable gestures do not go to waste, matching willing donors with compatible recipients regionally and across the United States, thereby saving lives and reducing massive wait lists for organ donations,” Portman said. “This new approach not only will make Toledo one of the world leaders in paired kidney transplantation, but also pave the way for a thriving, Toledo-based biotech industry, spurring job growth in northwest Ohio.”
“The research competitively funded today by the Department of Health and Human Services will undoubtedly save many lives, in addition to saving Medicare millions of dollars. Chronic kidney disease affects nearly one in 10 Ohioans and their families,” Kaptur said.
“The research done in paired kidney donation has the potential to save the health-care industry and Medicare more than $95 million by getting people off of dialysis and on with their lives. Only about 17,000 kidney transplants are performed each year, with tens of thousands of more Americans on the wait list for a new kidney. Nearly 5,000 people will die waiting for a kidney each year,” Kaptur said. “That’s why this research to improve kidney donation is so important. I congratulate Dr. Rees and The University of Toledo Medical Center for securing this funding.”
By establishing a standardized charge nationwide for the compatibility testing, removal and transplantation of a kidney, the United States could remove the business disincentive currently in place that inhibits kidney donations across states, across different insurance companies, and between Medicare and Medicaid and private insurers, Rees said.
“This grant will show this idea can work,” Rees said. “The next step will be convincing all parties involved that the concept works and then scaling this project up to the national level using the experience gained to save thousands of lives and millions of dollars every year going forward.”
In June, Rees and UTMC earned national acclaim for coordinating the first international altruistic kidney donation chain. An earlier chain that began in 2009 also has been covered by People Magazine and published in the New England Journal of Medicine.