Abstract: FR-OR086
Significant Increase and Variation in Organ Procurement Organization-Reported Deceased Donor Kidney Recovery Costs Between 2019 and 2024
Session Information
- The Changing Landscape of Kidney Transplantation: Clinical Innovation, Outcomes, and Health Policy
October 23, 2026 | Location: Mile High Ballroom 4A, Convention Center
Abstract Time: 05:00 PM - 05:10 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Ladd, Emma, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
- Joseph, Zachary I., Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
- Yu, Miko, Columbia University, New York, New York, United States
- Ekanayake, Cameron, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
- Lopez, Rocio, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Schold, Jesse D., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Husain, Syed Ali, New York University, New York, New York, United States
- Mohan, Sumit, Columbia University, New York, New York, United States
Group or Team Name
- CURE
Background
Introduction: From 2019 to 2024, the transplant system saw substantial expansion in deceased donor kidneys recovery and transplantation, while also seeing shifting incentives and increased complexity from KAS250 implementation and new Organ Procurement Organization (OPO) performance metrics. The impact of these policies on procurement costs remains unclear.
Methods
Using the OPO94 Cost Report dataset from CMS, we identified trends in reimbursable kidney recovery costs from 2019 to 2024. A reimbursable kidney was defined as one recovered or imported by the reporting OPO and eventually transplanted, consistent with CMS definitions.
Results
Among 51 OPOs, total reimbursable kidney procurement costs rose from $0.72 billion in 2019 to $1.51 billion in 2024 (109% increase). The average cost per reimbursable kidney rose among OPOs from $38,670 to $61,076 (58% increase). In 2024, per-kidney costs varied widely across OPOs ($40,693–$82,401), with no correlation between number of reimbursable kidneys and per-kidney costs (r = −0.05, p = 0.72).
From 2019 – 2024, kidney transport costs more than doubled, from $29 million to $74 million (4.05% to 4.93% of total OPO costs). Of 45 OPOs with transportation data, 32 reported greater than 100% increases in per-kidney transport costs. The average transport cost per reimbursable kidney rose from $1,390 to $3,277.
Conclusion
Discussion: Kidney procurement and transportation costs have grown substantially faster than transplant volume, with significant inter-OPO variation. Understanding the drivers of these cost increases is important as the OPTN works to improve organ procurement, utilization, and transplant access.