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Partners in Transplant
Partners in Transplant

Partnering together:

To support your work in bringing more appropriate patients to kidney transplantation before dialysis

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Providing information and tools to support
kidney transplantation for appropriate patients

Access to renal replacement therapy can be multifaceted, including health care and financial considerations for patients, payers, and health care systems. Some of these considerations, outlined below, may help improve access to kidney transplant for appropriate patients.

Patients added to the waitlist before dialysis have over twice the living donor rate vs those added after dialysis.

 

A man wearing a brown collared shirt indoors, with colorful blurred artwork in the background and a green circle displaying “44%” at the bottom.

of patients wait-listed before dialysis received a living donor kidney transplant 3 years after the preemptive listing1,*

A man wearing a blue shirt, resting his hands near his chin, with white shelves and decorative items in the background, and a purple circle displaying "3.3%" at the bottom.

of Medicare Advantage beneficiaries with incident end-stage renal disease (ESRD) are waitlisted before initiating dialysis2,†

A woman wearing a gray outfit with lace details, standing near a wooden wall with greenery in the background, and a green circle displaying "~40%" at the bottom.

of US preemptive kidney transplants received a living donor vs 18% of patients after the start of dialysis in 2023.

Put your patients with chronic kidney disease
(CKD) on the path to a pre-dialysis transplant.

Increasing access to pre-dialysis transplants may
benefit your transplant eligible beneficiaries2,4

Two kidney icons, the left outlined in purple and the right in green, connected by dotted lines in matching colors. Text in the center reads, "Annually there are ~131,000 patients diagnosed with kidney failure2,†."
Close-up of a person’s arm connected to a dialysis machine with multiple tubes and fluid containers, wearing a red sleeve, in a clinical setting.

 

Dialysis

Most of these patients will follow a path that leads them to dialysis2,†

A healthcare professional wearing a white coat and stethoscope talking to a person sitting indoors, with large windows and blurred outdoor scenery in the background.

 

Kidney Transplant

Only ~4% (4,524) of patients will receive preemptive kidney transplant (PKT), the therapy recommended by Kidney Disease Improving Global Outcomes (KDIGO guideline)2,5,†

Based on data reported in 2018, adjusted 5-year survival for patients with ESRD was2

 

A purple circle showing “40.7%” in white next to black text that reads “for patients on hemodialysis,” on a light purple background.
A green circle showing “91.5%” in white next to black text that reads “for patients who received a living donor kidney transplant,” on a light green background.
Green dot with white outline connected by a curved dashed line to a downward-pointing arrow.

For transplant eligible patients:

Icon of a document with a plus sign and a downward-trending arrow, outlined in green.

For appropriate patients:

Potentially eliminate or reduce medical spend for dialysis4

Table comparing per-patient annual spend for Medicare beneficiaries2,§: Dialysis costs ~$99,000, while kidney transplant costs ~$45,000.
Circle outlined in green and light green according to the percentage, showing “~55%” reduction with a downward arrow at the center on a white background.

A study demonstrated that despite the initial high cost associated with kidney transplant, PKT in
appropriate patients may lead to lower health care costs over time compared to maintenance dialysis9,¶

Estimated All-Cause Cumulative Health Care Costs for Maintenance Dialysis or PKT in a
36-Month Period in Medicare Advantage and Commercial Insurance Enrollees 9,¶

Line graph comparing treatment costs over follow-up months for PKT and maintenance dialysis. The x-axis shows follow-up months from 0 to 36, and the y-axis shows cost from 0 to $950,000. The green line represents PKT costs, and the purple line represents maintenance dialysis costs. The purple line rises more steeply, crossing above the green line within the first 5 months, while the green line shows PKT costs increasing gradually to about $350,000. A note on the graph reads: “Within 5 months, costs for maintenance dialysis were higher than costs for PKT.” Another note states: “-35% of estimated costs for the first year of PKT were largely attributable to the kidney transplantation procedure.” A legend below identifies green for PKT and purple for maintenance dialysis.
Text stating 36-Month All-Cause Health Care Costs for Medicare Advantage and Commercial Insurance Enrollees9,¶.
Chart showing maintenance dialysis $926,402 in purple text and PKT $366,872 in green text, with a $559,530 difference in costs in black.

Increasing access to kidney transplantation in appropriate patients with ESRD may offer up to $21,883,057 per million lives in annual savings, based on a hypothetical scenario2,#

Illustration with two pie charts showing prevalence percentages and estimated costs per 1 million lives. The left chart titled "Estimated cost per 1 million lives, 2022" shows prevalence: 57.9% in purple for in-center HD (1,385.5), 32.2% in green for PKT (770.5), 8.3% in purple for PD (198.4), and 1.6% in purple for home HD (38.3). Green arrow indicates cost $34,771,124, and purple arrow indicates $159,069,768. The right chart titled "Hypothetical estimated cost per 1 million lives" shows prevalence: 43.0% in purple for in-center HD (1,029.0), 50.0% in green for PKT (1,196.5), 5.0% in purple for PD (119.6), and 2.0% in purple for home HD (47.8). Green arrow shows cost $53,995,652, and purple arrow shows $117,962,183. A color legend below indicates green for PKT and purple for Maintenance dialysis.
Icon of an open book with text lines and a kidney icon at the top center, outlined in green.

For appropriate patients:

Increase living donor transplant rates by providing kidney disease education6

Only 5.6% of patients with incident ESRD were waitlisted before the initiation of dialysis2,‖

Early kidney disease education (KDE) (eg, at CKD stage 4) can lead to an increased use of living donor PKT6,**

Circle outlined in green and light green according to the percentage, showing “69%” at the center, with text below reading, “of kidney transplant candidates underwent a living kidney donor transplant with early education6,**."

A study evaluated kidney transplant outcomes associated with receipt of KDE among patients with ESRD9,††

Compared with patients who did not receive KDE, receipt of KDE increased the likelihood of:

Receiving a kidney
transplant by

 

A smiling man wearing a green sweater with trees in the background, accompanied by a green circular icon showing “41%” with an upward arrow below it, and text indicating “HR: 1.41; 95% Cl: 1.19–1.66.”

Being placed on a
kidney transplant waiting list

 

A smiling man wearing a light green long-sleeve shirt and black vest, sitting with ocean waves in the background, accompanied by a green circular icon showing “41%” with an upward arrow below it, and text indicating “HR: 1.41; 95% Cl: 1.24–1.62.”

Being evaluated for a kidney
transplant by

 

A woman wearing a green short-sleeve top, seated indoors with a bookshelf and lamp in the background, accompanied by a green circular icon showing “51%” with an upward arrow below it, and text indicating “HR: 1.51; 95% Cl: 1.27–1.78.”

In 2018, only ~1% of eligible patients with CKD stage 4 had a claim for kidney disease education10

Utilization of the CMS KDE benefit resulted in:

Increase in pre-ESRD wait-listing11,‡‡

 

A smiling woman wearing a light green T-shirt, standing outdoors with greenery and a blurred city in the background, accompanied by a green circular icon showing “38%” with an upward arrow below it.

Increase in PKT11,‡‡

 

A smiling man wearing a light green T-shirt and earphones, outdoors with greenery in the background, accompanied by a green circular icon showing “36%” with an upward arrow below it.

Use of the Centers for Medicare and Medicaid (CMS) KDE benefit can help increase your PKT population.11

Icon of two open hands below a heart shape, outlined in green.

For appropriate patients:

Improve fragmented care7

CKD/End-Stage Renal Disease (ESRD) Patient journey2

Illustration showing stages of chronic kidney disease progression. A pink kidney labeled “CKD Stage 4” shows 3,400 of 1M patients with CKD§§. An arrow leads to a darker red kidney labeled “CKD Stage 5” with 1,500 of 1M patients with CKD§§. Another arrow leads to a dark brown kidney labeled 'Renal Replacement Therapy,' branching into two boxes: a purple box with an icon of a person receiving IV infusion, labeled Dialysis 97% (126,209) of patients with ESRD start dialysis†, and a green box with an icon of a human body with kidneys highlighted and one kidney zoomed, labeled “PKT 4% (4,524) of patients with incident ESRD receive a PKT†.”

Identifying and educating patients with CKD earlier can improve care and reduce barriers to transplant.11

Calculate your patient's Estimated Post Transplant Score (EPTS) to identify recipients who may
benefit most from rapid waiting list placement and transplantation.1

Candidates are less likely to lose their top-tier EPTS status when they are preemptively wait-listed.1

Icon of five human silhouettes, with one solid green figure in the center and four lighter green figures surrounding it.

From 2015-2017, only 1 in 5 kidney
transplant candidates with top-tier EPTS
scores were preemptively wait-listed for
transplant.1

Icon of two green kidneys next to a circular progress chart outlined in green and light green according to the percentage, showing “20%” in text at the center.

Candidates with a top 20% EPTS
status have preferential access to deceased
donor kidney offers with the lowest
cumulative risk factors.1

Icon of a clipboard with a kidney-shaped element on the left, next to a circular progress chart outlined in green and light green according to the percentage, showing “37%” at the center.

Only 37% of patients with top 20% ETPS
status were added to the waiting list within 3
years of dialysis initiation.1

Icon of two human figures with raised arms and sparkles around them, outlined in green.

For appropriate patients:

Improve health outcomes7

With a living donor, your kidney transplant candidates may achieve:

A smiling elderly woman in a wheelchair with a young healthcare worker wearing green scrubs, accompanied by a green circular chart showing “~60%” with an upward arrow at the center, and text below reading “lower rates of delayed graft function¶¶ vs non-PKT13.”
A smiling older woman with curly hair and sunglasses, wearing a green top, standing on a beach, accompanied by a green circular chart showing “~125%” with an upward arrow at the center, and text below reading “increase in 5-year survival vs hemodialysis2##.”
Icon of two kidneys above a medical box with a cross on the front, outlined in green.

For appropriate patients:

Understand reimbursement of kidney transplants8

CMS reimbursement for kidney transplant admissions may vary depending on the assigned Medicare Severity Diagnosis Related Group (MS-DRG).8
 

Thumbnail of resources from the Milliman report, commissioned by Sanofi.

Kidney transplant admissions infographic 

Download the infographic
Thumbnail of “Information on MS-DRG payment rates."

Medicare MS-DRG payment system

Download resource on MS-DRG payment rates

Stay up-to-date with professional guidelines5,14

Educate at CKD stage 4, refer at CKD stage 4, and transplant at CKD stage 514,‖‖

A healthcare professional wearing a white coat and stethoscope, and a name badge, seated indoors, engaged in conversation with another person in a clinical setting.

The following guidelines assist health care professionals in the field of kidney transplantation to evaluate and manage care for their patients

To learn more, click on the individual guidelines below:

Read KDIGO Guidelines Read OPTN Guidance

Resources to support your appropriate patients on the journey to
living donor PKT

The Advancing American Kidney Health (AAKH) Initiative aims to double the number of kidneys available for transplant by 2030, through strategies such as increasing available options for individuals in need of kidney transplants and access to PKT.7

Bring the experts in kidney transplant education to your patients! Click on each resource to learn more.

Two individuals seated indoors, one wearing a white coat and holding a tablet, showing it to the other person, accompanied by a text reading “EXPLORE Transplant."

EXPLORE Transplant

Go to website
An elderly man seated outdoors in a wheelchair, wearing a gray sweater, with blurred greenery in the background, accompanied by a text reading "Medicare.gov".

CMS Kidney Disease Education Benefit

Go to website
A healthcare professional wearing a white coat and stethoscope, holding a clipboard, speaking with another person indoors, accompanied by a text reading “THE KIDNEY FAILURE RISK EQUATION.”

Kidney Failure Risk Equation

Go to website
An elderly man sitting indoors on a couch, holding a tablet device, accompanied by a text reading “OPTN Organ Procurement & Transplantation Network.”

EPTS Calculator

Go to website
An elderly woman seated outdoors on a wooden bench, wearing a maroon polka-dot top, with green foliage in the background, and the “AST AMERICAN SOCIETY OF TRANSPLANTATION® ” logo visible in the image.

American Society of Transplantation (AST) Living Donor Toolkit

Go to website
Two smiling women in a medical setting, one in blue scrubs with a stethoscope and the other in a blazer with a green lanyard, conversing in front of blurred hospital curtains. The National Kidney Foundation logo with an orange kidney shape is overlaid in the bottom left.

Living Donation Business Case Toolkit

Go to website

Work with kidney health management companies specializing in kidney transplants:

Logo for Rejuvenate Kidney Transplant Solutions. A teal and green geometric emblem is next to the word "REJUVENATE" in gray, with "Kidney Transplant Solutions" in teal text below.
Logo for project donor. The words "project" and "donor" are in teal text, each inside a box with arrows pointing in opposite directions to suggest a cycle.
Logo for patients.app. A white-outlined network icon is to the left of the lowercase text "patients.app" on a black background.
Logo for Give to Live Health. A geometric, blue-gray hexagonal emblem is above the words "Give to Live Health" in gray serif text.
Logo showing an abstract blue medical symbol formed by overlapping curved lines above the word "CareNostics" in gradient blue text.

This listing is provided as a resource only and does not constitute an endorsement by Sanofi of any particular organization or its programming. Additional resources on this topic may be available and should  be investigated. Sanofi does not review or control the content of non-Sanofi websites.

 

 

Learn about PKT and the Benefits of
Kidney Transplant

Download Sanofi's Transplant Opportunity Brochure

 

 

Strategies that align with the goals of the Increasing Organ Transplant
Access (IOTA) model

Thumbnail of infographic handout titled "Path to Preventive Kidney Transplant."

Path to PKT

Download the resource
Thumbnail of infographic handout titled “Achieving Equity in Kidney Transplantation.”

The Value of Transplant Centers to Hospitals and Health Care Systems

Download the resource

Learn more about the staggering disparities faced by those in need of kidney transplant

Thumbnail of infographic handout titled “Disparities Appear Throughout the Kidney Transplant Patient Journey.”

Disparities Appear Throughout the Kidney Transplant Patient Journey

Download the resource
Thumbnail of infographic handout titled “Achieving Equity in Kidney Transplantation.”

Achieving Equity in Kidney Transplantation

Download the resource
Video thumbnail of a USA map outlined in purple, with “In 2018” displayed at the top left above it, and text reading, “87% of patients living in the US with ESRD were non-white1."

Disparities in Kidney Transplantation

            

 

 

 

Abbreviations, footnotes, and references  

AAKH, Advancing American Kidney Health; AST, American Society of Transplantation; CKD, chronic kidney disease; CMS, Centers for Medicare and Medicaid Services; DD, deceased donor; EPTS, estimated post transplant score; ESRD, end-stage renal disease; FFS, fee for service; HD, hemodialysis; HR, hazard ratio; IOTA, Increasing Organ Transplant Access; KDE, kidney disease education; KDIGO, Kidney Disease Improving Global Outcomes; MS-DRG, Medicare Severity Diagnosis Related Group; OPTN, Organ Procurement & Transplantation Network; PD, peritoneal dialysis; PKT, preemptive kidney transplant; PPPY, per person per year; RRT, renal replacement therapy; USRDS, United States Renal Data System.

* Study included individuals ≥18 years of age (N=42,445) in the USRDS with top 20% EPTS scores. Patients had been preemptively waitlisted or had initiated dialysis between 2015-2017.1

† Incident cases of ESRD in 2022, USRDS.2

‡ Based on 6,418 living donor kidney transplants of 27,759 total kidney transplants; OPTN.3

§ Inflation-adjusted PPPY 2022.2  

a The following is only the reference data we will show for RC approval. Data shows 1,994 LD procedures from a total of 4,949 preemptive kidney transplants = 40%. After dialysis population is 4,054 LD divided by 22,402 total transplants after dialysis (18%). OPTN/SRTR 2023 Annual Data Report: Kidney

Data shown are cumulative estimates. Based on a retrospective, observational cohort study using data on patients with ESRD from Optum Clinformatics Data Mart (2012-2021). All-cause medical and pharmacy costs were compared between patients who received PKT and those who received maintenance dialysis. Of patients who survived the 12-month follow up period, 1,530 received PKT and 14,763 received dialysis. Of patients who survived the 36-month follow up period, 551 received PKT and 6,199 received dialysis.9

# In 2022, there were 2,393 ESRD beneficiaries per 1 million lives (prevalence rate from USRDS ESRD database). Costs were based on the per person per year Medicare FFS spending for ESRD beneficiaries in 2022 ($99,369 for in center HD; $113,890 for home HD; $85,845 for peritoneal dialysis; $45,128 for transplant). The estimated cost per 1 million lives for dialysis was calculated using prevalence percentages of in-center HD (57.9%), home HD (1.6%), and peritoneal dialysis (8.3%). The calculated costs per 1 million lives for in-center HD, home HD, and peritoneal dialysis were then added to estimate the total dialysis cost per 1 million lives. For the hypothetical case, the prevalence percentage for dialysis was assumed to be 43% for in-center HD, 2% for home HD, and 5% for peritoneal dialysis, and the prevalence percentage for transplant was assumed to be 50%. The estimated annual savings was based on the difference between 2022 actual costs and a hypothetical plan, with savings calculated per 1 million lives.2

‖ Incident cases of ESRD in 2022, United States Renal Data System (USRDS) ESRD and OPTN waiting list history.2

** A group education session covering renal replacement therapy options (RRT) was conducted in adults aged >18 years with ESRD (n=80) in the Netherlands (2011-2013); RRT outcomes (date and type) up to 2 years post intervention were collected.6

†† Retrospective cohort study of patients aged ≥18 years used data from the Medicare-linked United States Renal Data System (2009-2019). Of all eligible patients with ESRD, 1.5% (7,838 of 519,902) received KDE; most patients (85.6%) had stage 4 CKD with comorbidities.9

 

‡‡ Based on 2013-2017 US data from adults aged ≥67 years who had CKD stage 4 (n=106,465); use of kidney disease education was examined in the 2 years prior to ESRD onset.11

 

§§ Based on prevalence of CKD in 2020.2

¶¶ Among PKT recipients.13

 

## Based on survival probability of living donor transplant vs hemodialysis reported for 2018.2

‖‖ CKD stage 4, estimated glomerular filtration rate (eGFR) 15-29 mL/min/1.73 m2; CKD stage 5, eGFR <15 mL/min/1.73 m2 or on dialysis.14

 

1. Schold JD, et al. J Am Soc Nephrol. 2021;32(7):1733-1746

2. United States Renal Data System. 2024 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2024

3. National data. Organ Procurement & Transplantation Network. Accessed January 31, 2025. https://optn.transplant.hrsa.gov/data/view-data-reports/ national-data/.

4. Optum. Kidney Solutions: Preemptive Transplants Rates and Cost Savings. Eden Prairie, MN; Optum Inc; August 2021

5. Chadban SJ, et al. Transplantation. 2020;104(4)(suppl 1):S11-S103.

6. Massey EK, et al. Nephrol Dial Transplant. 2016;31(5):823-830

7. US Department of Health and Human Services. Advancing American kidney health. https://aspe.hhs.gov/sites/default/files/private/pdf/262046/ AdvancingAmericanKidneyHealth.pdf. Accessed February 4, 2025

8. Healthcare Financial Management Association. Final rule summary: fiscal year 2021 Medicare hospital inpatient prospective payment system and longterm care hospital prospective payment system final rule. https://www.hfma.org/wp-content/uploads/2022/10/fy21-inpatient-prospective-paymentsystem-final-rule-summary.pdf. Accessed February 5, 2025

9. Data on file. Sanofi; 2025

10. United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2020

11. Johansen KL, et al. J Am Soc Nephrol. 2020;31(suppl):18. Kidney Week abstract FR-OR11

12. Helmick RA, et al. Transplant Direct. 2018;4(4):e356. doi:10.1097/TXD.0000000000000773.

13. Huang Y, et al. Nephrol Ther. 2012;8(6):428-432

14. Educational guidance on patient referral to kidney transplantation. Organ Procurement & Transplantation Network. https://optn.transplant.hrsa.gov/ professionals/by-topic/guidance/educational-guidance-on-patient-referral-to-kidney-transplantation/. Accessed February 5, 2025.