Frontiers in public health · 2026
Kidney transplantation versus maintenance dialysis in 14 EU countries: cost savings, payback time, and budget impact.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Iuga Horia, Balcı Mehmet Ali, Mihon Simion, Akgüller Ömer, Elec Florin Ioan
Аннотация
PURPOSE: To assess the economic benefit and payback period of kidney transplantation compared to maintenance dialysis across 14 European Union countries (2019 and 2023), with a focus on living-donor transplantation.
METHODS: A longitudinal country panel was compiled from European registry and national report. Cost-benefit analysis calculated annual net savings and break-even time, and cost-utility analysis estimated quality-adjusted life year gains using published utility weights with survival adjustment. A Graph-Regularized Neural Ordinary Differential Equations framework was introduced to capture nonlinear temporal dynamics and cross-country interactions, and its predictive performance was benchmarked compared against linear cost-benefit calculations and two-way fixed-effects regression using root mean squared error.
RESULTS: Transplantation was economically dominant in all country-years. Mean annual net savings were $37,471 and mean break-even time was 3.12 years (0.5-6.8). Incremental quality-adjusted life years averaged 4.38. Countries with living-donor share above 20% had shorter payback than those at or below 20% (2.01 vs. 4.28 years). The findings support the widespread economic superiority of transplantation over dialysis across the healthcare systems of all nations under investigation.
CONCLUSION: Living kidney transplantation consistently offers cost savings and health benefits across all health systems in the European Union. However, its scalability depends on country-specific payback periods, which are primarily influenced by upfront transplant costs.
METHODS: A longitudinal country panel was compiled from European registry and national report. Cost-benefit analysis calculated annual net savings and break-even time, and cost-utility analysis estimated quality-adjusted life year gains using published utility weights with survival adjustment. A Graph-Regularized Neural Ordinary Differential Equations framework was introduced to capture nonlinear temporal dynamics and cross-country interactions, and its predictive performance was benchmarked compared against linear cost-benefit calculations and two-way fixed-effects regression using root mean squared error.
RESULTS: Transplantation was economically dominant in all country-years. Mean annual net savings were $37,471 and mean break-even time was 3.12 years (0.5-6.8). Incremental quality-adjusted life years averaged 4.38. Countries with living-donor share above 20% had shorter payback than those at or below 20% (2.01 vs. 4.28 years). The findings support the widespread economic superiority of transplantation over dialysis across the healthcare systems of all nations under investigation.
CONCLUSION: Living kidney transplantation consistently offers cost savings and health benefits across all health systems in the European Union. However, its scalability depends on country-specific payback periods, which are primarily influenced by upfront transplant costs.