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ウナガミ コウヘイ
UNAGAMI Kouhei
海上 耕平 所属 医学部 医学科（東京女子医科大学病院） 職種 講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | The medical cost and outcome of desensitization protocol in kidney transplantation recipients with high immunological risks. |
| 掲載誌名 | 正式名：International journal of urology : official journal of the Japanese Urological Association 略 称：Int J Urol ISSNコード：09198172/14422042 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 31(4),pp.422-429 |
| 著者・共著者 | Maenosono Ryoichi, Unagami Kohei, Oki Rikako, Fujiwara Yuya, Banno Taro, Okada Daigo, Yagisawa Takafumi, Kanzawa Taichi, Hirai Toshihito, Omoto Kazuya, Hanafusa Norio, Azuma Haruhito, Takagi Toshio, Ishida Hideki |
| 担当区分 | 2nd著者,責任著者 |
| 発行年月 | 2024/04 |
| 概要 | Background: Kidney transplantation is a well-established alternative in renal replacement therapy. Compared with hemodialysis, low-immunological-risk kidney transplantation can reduce the medical treatment costs associated with end-stage renal disease. However, there are few reports on whether high-immunological-risk kidney transplantation reduces the financial burden on governments. We investigated the medical costs of high-immunological-risk kidney transplantation in comparison with the cost of hemodialysis in Japan.
Methods: We compared the medical costs of high-immunological-risk kidney transplantation with those of hemodialysis. 15 patients who underwent crossmatch-positive and/or donor-specific antibody-positive kidney transplantations between 2020 and 2021 were enrolled in this study. The patients received intravenous immunoglobulin, plasmapheresis, and rituximab as desensitizing therapy. Results: Acute antibody-mediated rejection was detected in nine (60%) recipients, while there were no indications of graft function deterioration during the follow-up. For each patient, the transplant hospitalization cost was 38 428 ± 8789 USD. However, the cumulative costs were 59 758 ± 10 006 USD and 79 781 ± 16 366 USD, at 12 and 24 months, respectively. Compared with hemodialysis (34 286 USD per year), high-immunological-risk kidney transplantation tends to be expensive in the first year, but the cost is likely to be lower than that of hemodialysis after 3 years. Conclusions: Although kidney transplantation is initially expensive compared with hemodialysis, the medical cost becomes advantageous after 3 years even in kidney transplant recipients with high immunological risk. |
| DOI | 10.1111/iju.15383 |
| PMID | 38193573 |