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Timing of Medicare Loss May Affect Long-Term Success of Kidney Transplantation

Kidney transplant recipients under 65 years of age qualify for Medicare coverage following transplantation, but coverage ends after three years. A new American Journal of Transplantation study found that failure of the transplanted kidney was 990 percent to 1630 percent higher for recipients who lost Medicare coverage before this three-year time point compared with recipients who lost Medicare on time. 

Wednesday, March 6, 2019 12:01 am EST
"Our findings strongly suggest that we need to more closely evaluate the health care system we have in place to make sure these transplanted patients don’t end up back on dialysis simply because they can’t afford the care they need."

Kidney transplant recipients under 65 years of age qualify for Medicare coverage following transplantation, but coverage ends after three years. A new American Journal of Transplantation study found that failure of the transplanted kidney was 990 percent to 1630 percent higher for recipients who lost Medicare coverage before this three-year time point compared with recipients who lost Medicare on time. Those who lost coverage after this point had a lesser, but still marked, increased risk of kidney failure.

Recipients who lost coverage before or after the three-year time point also filled immunosuppressive medications at a significantly lower rate than those who lost coverage on time.

The study included 78,861 Medicare-covered kidney transplant recipients under 65 years of age.

The findings have significant policy implications, and they suggest that a close examination of the risks of Medicare loss, as well as the importance of medical coverage safety nets and access to immunosuppressive medications, must be examined.

"Kidney transplantation has profound survival, quality of life, and cost benefits over dialysis for the treatment of end-stage kidney disease, and yet thousands of patients die every year while waiting for a kidney because it is such a scarce resource,” said lead author Dr. Allyson Hart, of Hennepin Healthcare and the University of Minnesota, in Minneapolis. “Our findings strongly suggest that we need to more closely evaluate the health care system we have in place to make sure these transplanted patients don’t end up back on dialysis simply because they can’t afford the care they need.”

Additional Information

Link to Study: https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.15293 

About Journal 

The aim of the American Journal of Transplantation is the rapid publication of new, high-quality data in organ and tissue transplantation and the related sciences.The journal reflects the field and is an agent for advancing it through critical reviews and news features, consensus documents, and guidelines. The journal is directed at scientists and clinicians in transplantation but also at those in other fields who wish to follow transplantation.

The scope is the international discipline of transplantation. This includes organ and tissue donation and preservation; tissue injury, repair, inflammation, and aging; immune recognition, regulation, effector mechanisms, and opportunities for induction of tolerance; histocompatibility; drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses; transplant complications; xenotransplantation; and ethical and societal issues. The sciences includes relevant aspects of cell biology, medicine, surgery, pediatrics, and infectious diseases. The journal includes thoracic transplantation (heart, lung), abdominal transplantation (kidney, liver, pancreas, islets), transplantation of tissues and related topics.

About Wiley

Wiley is a global leader in research and education. Our online scientific, technical, medical, and scholarly journals, and our digital learning, assessment, certification and student-lifecycle services and solutions help universities, academic societies, businesses, governments and individuals to achieve their academic and professional goals. For more than 200 years, we have delivered consistent performance to our stakeholders. The Company's website can be accessed at www.wiley.com.

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