Costs of Deciding to Transplant
Before a patient is referred to a transplant center for an unrelated allogeneic transplant, exams and tests are needed. Because these medical costs vary by region of the country and other factors, the common procedures are listed. Services and costs to the patient and patient’s family are also listed. Costs when deciding to transplant:
1. Assessing the patient’s health and disease statusPhysician, pharmacy and laboratory costs to determine if a hematopoietic cell transplant is the best therapy treatment often include:
- Heart assessments such as an electrocardiogram (ECG or EKG) and two-dimensional echocardiogram or multiple gated acquisition (MUGA) scan
- Pulmonary function tests such as diffusion capacity (DLCO), forced expiratory volume (FEV), and forced capacity (FVC)
- Liver tests to assess veno-occlusive disease (VOD)
- Kidney tests such as serum creatinine and creatinine clearance
- Dental exam and X-rays
Karnofsky performance assessment (ability to perform daily tasks)
- Human leukocyte antigen (HLA) typing (A, B, C, DRB1) at high resolution
- Bone marrow biopsy
- Complete blood count (CBC)
Costs to the patient may include:
- Sperm or egg storage
- Insurance premiums and household costs when the patient or family member is unemployed
2. Checking for a related donor and planning for an unrelated donor search strategy
Transplant center's laboratory costs include HLA typing of the patient’s immediate family. HLA testing of family members determines the availability of a related donor and can help plan a strategy to search for an unrelated donor or cord blood unit.
3. Identifying a caregiver
The patient needs to identify someone to care for him or her before, during and after the transplant.
Costs to the caregiver include lack of employment income and time commitment. It also may include lodging near the transplant center, transportation, and living expenses away from home.
Steps 3 and 4 must be completed before a formal search can be activated. A time delay could prevent the patient from receiving a transplant or reduce the effectiveness of the transplant.
4. Referring the patient to a transplant center that performs unrelated hematopoietic cell transplants Costs depend upon the location of the transplant center and other factors.
Travel and lodging costs for:
- Long-distance travel to and from the transplant center and local lodging
- Daily living while staying near the transplant center such as food, parking and transportation
Costs to the patient, patient’s family and caregiver may include child care.
- Patients can find information about insurance coverage, indirect expenses, and financial assistance at Planning for Transplant Costs (marrow.org).
More information:Steps: Deciding to Transplant
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