Kidney transplantation is the treatment of choice for patients with end-stage renal disease needing renal replacement therapy. The availability of kidney donors is not easily available in Malaysia due to one reason or another. When there are kidney donors for kidney transplants, their suitability needs to be screened. The kidney transplant workup and follow-up can be time-consuming, physically draining, work-hindering, and a financial burden in the kidney transplant process, especially for the poor. Besides the medical screening for their suitability, their psychosocial status needs to be screened too to avoid default or delay to kidney transplant and prevention of graft failure.
The NKF Kidney Transplant Subsidy was planned out of NKF Strategic Plan 2022-2026 on 20 May 2022. Its first proposed budget allocation was approved by the NKF Patient Selection & Welfare Committee on 29 July 2022 which was subsequently concurred by the NKF Board of Directors and Annual General Meeting on 10 September 2022. The NKF Kidney Transplant subsidy is implemented in 2023.
2. Purpose & Structure:
The NKF Kidney Transplant subsidy is targeted at low-income and lower-middle-income earners who are deserving of the subsidy financial assistance which can benefit them in the kidney transplant process from pre-transplant screening and workup, the transplant period, and post-kidney transplant care and support at government hospitals.
A referral by a government hospital nephrologist to a private setting can be considered for this subsidy where services are not available or limited in government hospitals, including university hospitals. It is to remove the financial barriers for the deserving who choose kidney transplants as the renal replacement therapy option.
However, this subsidy is not intended for the payment of surgical fees at the private medical centres as government hospitals have the capacity to perform kidney transplant surgery or provide immunosuppression therapy which is the responsibility of the government hospitals and was expressed as sufficient for the local kidney transplanted patients.
3. Examples of NKF Kidney Transplant coverage:
NKF will start out with a focus on the socioeconomic needs of a kidney transplant. The amount of subsidy given to patients will depend on their financial status as assessed by the NKF Welfare Department. The targeted areas of NKF Kidney Transplant subsidy at government hospitals, including university hospitals or being referred by government hospitals to private medical centres, are as below:
i. Pre-Kidney Transplant Phase:
a. Blood tests, e.g., genetic, immunology, etc;
b. Pre-kidney transplant screening eg cardiac & imaging workup;
c. Travelling expenses for ‘out of town’ patients;
d. Lodging expenses for ‘out-of-town’ patients;
e. Income loss replacement for donor’s workup (Note: MC not accepted by many employers for kidney transplant);
f. Other pre-kidney transplant work-ups, where services/facilities are not available at government hospitals and needed in private settings;
g. Other areas, where the need for kidney transplant screening is not available in government hospitals or being referred by government hospitals to private medical centres.
ii. Transplant Phase:
a. Travelling expenses;
b. Lodging expenses for the patient, donor, and career;
c. Subsistence for the poor, from pre to post-kidney transplant, as needed;
d. Income loss for the donor during the recuperating stage
iii. Post-Kidney Transplant Phase:
a. Travelling expenses for follow-up
d. Income loss,
4. Application and Disbursement Process (Workflow for NKF Kidney Transplant Subsidy)