grantor:
University of TorontoTransplantation compared to dialysis offers superior life-expectancy and quality of life for young patients with renal failure. However the initial risks of mortality and morbidity are high, especially with increasing age. This study uses a decision analysis model to evaluate the costs and benefits of kidney transplantation versus continued dialysis for an older patient with renal failure. A decision analysis framework was built using SMLTREE software. The base case focused on a 65 year old white, non-diabetic male. Probability, utility and life expectancy data were obtained from the literature and renal registries. Life-expectancy on dialysis was 2.9 quality-adjusted years at a cost of $338,335. Life expectancy with transplantation was 4.2 quality-adjusted years at a cost of \$249,440. The cost-effectiveness analysis showed a dominant situation. Sensitivity analysis revealed that the results were stable across most variables. Transplantation is cost-effective when compared to dialysis for older individuals, suggesting that it should be offered more frequently to well-selected patients.M.Sc
