Kidney Transplant Costs

doontp · June 10, 2021

I have Stage 5 kidney disease and I'm trying to learn a rough cost of receiving a kidney from a living donar. The donar (my wife) and recipient (myself) in this situation are both Thai Nationals.

We currently reside in the US with plans to permanantly return to LOS early next year. Both of us are not very familiar with how the Thai medical system works financially.

Would the Thai Universal Health Scheme cover us?

I'm also trying to figure out which hospital ranks best for this procedure..........SirIraj or Bumrungrad or maybe another hospital?

I appreciate any available information. Thank you.

Sheryl · June 10, 2021

As Thai citizens you will be covered under the Universal Health Scheme. In the provinces,people will have to be registered at one (government) hospital under it and then can get care elsewhere if referred (obviously for something like transplant, which only tertiary hospitals do, most hospitals would have to refer). I am not certain how this works in Bangkok, though - better to ask the NHSO - but it will certainly still be limited to government hospitals

https://www.nhso.go.th/

So you need to think in terms of government hospitals on;ly.

In Bangkok the 2 with the most experience in kidney transplants are Chulalongkorn and Ramathibodhi.

doontp · June 10, 2021

3 hours ago, Sheryl said:

As Thai citizens you will be covered under the Universal Health Scheme. In the provinces,people will have to be registered at one (government) hospital under it and then can get care elsewhere if referred (obviously for something like transplant, which only tertiary hospitals do, most hospitals would have to refer). I am not certain how this works in Bangkok, though - better to ask the NHSO - but it will certainly still be limited to government hospitals

https://www.nhso.go.th/

So you need to think in terms of government hospitals on;ly.

In Bangkok the 2 with the most experience in kidney transplants are Chulalongkorn and Ramathibodhi.

Thank you for the reply. My wife owns a small condo in Nonthaburi and I think we are both registered at Siriraj Hospital.

We each have an ID Card from them and I paid for services rendered during a 2019 visit. I'm not complaining, but just pointing it out.

Is it one of those deals where they present a bill and you pay if and whatever you can? Because if I recall correctly, the clerk did ask if we were able to pay and I responded with a "yes."

Sheryl · June 10, 2021

No, if their system shows you as under the UHC you do not have to pay except for any charges not included (like if you opt for private room - in that case they subtract the normal eard room rate and you pay the difference).

Do you have Thai ID card? If so, showing what address? As UHC registration is based on your ID card.

If it shows Nonthaburi you may have to register first at Phra Nang Klao Hospital which is the provinicial hospital for Nonthaburi. Then get them to refer you which for kidney transplant should be easy.

Sheryl · June 10, 2021

There is normally a long wiat list for kidney transplants in Thailand. While having a living donor should help, even then, there may be a wait just for the surgery. Just so you know.

doontp · June 10, 2021

3 hours ago, Sheryl said:

No, if their system shows you as under the UHC you do not have to pay except for any charges not included (like if you opt for private room - in that case they subtract the normal eard room rate and you pay the difference).

Do you have Thai ID card? If so, showing what address? As UHC registration is based on your ID card.

If it shows Nonthaburi you may have to register first at Phra Nang Klao Hospital which is the provinicial hospital for Nonthaburi. Then get them to refer you which for kidney transplant should be easy.

Yes, my wife and I both have a Thai ID Card. My ID Card shows me registered under my address in Amnatcharoen. My wife's ID Card shows her registered under her address in Nonthaburi. We will update my ID Card to show the address of my wife's condo in Nonthaburi upon our return.

I own a small house in Amnatcharoen. I rarely ever travel there. I only go there to visit old relatives and I need a comfortable private place to sleep. That's it.

I became aware of my kidney disease about 10 days ago, so we are still in the planning stage of this process.

I am also looking into the possibility of traveling back to the US when a kidney becomes available. I have already been placed on the kidney waiting list. The average wait time is 3-5 years.

Is there any idea what the wait time in Thailand is for living donar transplants?

You have already been such a good source of info. Thank you.

Sheryl · June 11, 2021

14 hours ago, doontp said:

Yes, my wife and I both have a Thai ID Card. My ID Card shows me registered under my address in Amnatcharoen. My wife's ID Card shows her registered under her address in Nonthaburi. We will update my ID Card to show the address of my wife's condo in Nonthaburi upon our return.

I own a small house in Amnatcharoen. I rarely ever travel there. I only go there to visit old relatives and I need a comfortable private place to sleep. That's it.

I became aware of my kidney disease about 10 days ago, so we are still in the planning stage of this process.

I am also looking into the possibility of traveling back to the US when a kidney becomes available. I have already been placed on the kidney waiting list. The average wait time is 3-5 years.

Is there any idea what the wait time in Thailand is for living donar transplants?

You have already been such a good source of info. Thank you.

Yes, change your ID to Nonthaburi and then register at the local provincial hospital (Phra Nang Klao ) and seek a referral form from them to consult transplant specialists at one of the national hospitals (bring your US records with you). Siriraj would be fine and is obviously more convenient to you than Chula or Ramathibodhi. ANy problems with regard to the universal cover, contact the NHSO. They have a helpline and are very responsive, will help intervene with hospitals when necessary.

Unfortunately I have no idea about wait time for a transplant using a living donor but in general at the university hospitals in Phnom Penh the wait list for non-emergency surgery is long, sometimes as much as a year. Due to COVID many procedures have been postponed so once that eases there may be much longer waits do to backlog.

While the wait time for a donor in US averages 3-5 years, with a living donor it should be possible to get the surgery fairly quickly i..e within the year, maybe even within a few months. This of couyrse assumes your wife is a match - has she been tested?

It would frankly be far better for you to get this done in the US and relocate to Thailand only once stable. While transplant can be done here, waits will be longer and soem aspects of care not as high.

doontp · June 11, 2021

6 hours ago, Sheryl said:

Yes, change your ID to Nonthaburi and then register at the local provincial hospital (Phra Nang Klao ) and seek a referral form from them to consult transplant specialists at one of the national hospitals (bring your US records with you). Siriraj would be fine and is obviously more convenient to you than Chula or Ramathibodhi. ANy problems with regard to the universal cover, contact the NHSO. They have a helpline and are very responsive, will help intervene with hospitals when necessary.

Unfortunately I have no idea about wait time for a transplant using a living donor but in general at the university hospitals in Phnom Penh the wait list for non-emergency surgery is long, sometimes as much as a year. Due to COVID many procedures have been postponed so once that eases there may be much longer waits do to backlog.

While the wait time for a donor in US averages 3-5 years, with a living donor it should be possible to get the surgery fairly quickly i..e within the year, maybe even within a few months. This of couyrse assumes your wife is a match - has she been tested?

It would frankly be far better for you to get this done in the US and relocate to Thailand only once stable. While transplant can be done here, waits will be longer and soem aspects of care not as high.

My wife and I have the same blood type, but she has not been tested. She's concerned that donating a kidney would lessen her chances of getting pregnant.

We have been discussing options and possibilities.

Sheryl · June 12, 2021

13 hours ago, doontp said:

My wife and I have the same blood type, but she has not been tested. She's concerned that donating a kidney would lessen her chances of getting pregnant.

We have been discussing options and possibilities.

Having the same blood type is a requirement but does not mean she is a match, would still have to do a tissue typing.

Donating a kidney has no effect on the ability to conceive, though it is recommended to wait 6 months after the procedure. There is a very small increase in the risk of pregnancy complications.

The main implication for the donor is that they are more vulnerable to the effects of kidney disease in the future since they have only one functioning kidney. And trauma to the remaining kidney (from an accident etc) would be life threatening.

Good overviews here. The fiorst oen addresses pregnancy

https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation

https://weillcornell.org/services/kidney-and-pancreas-transplantation/living-donor-kidney-center/about-the-program/risks-and-benefits-of-living-donation

If you are considering waiting for a cadaver kidney (donation from dead person) you should definitely stay in the US as the wait is longer in Thailand.

mrmicbkktxl · June 12, 2021

On 6/10/2021 at 11:55 AM, Sheryl said:

people will have to be registered at one (government) hospital

How to register a Thai person?If a Thai moves from one district to another in the same province does he/she needs to unregister from one hospital first or can go to the new hospital right away?What documents are required?

Sheryl · June 12, 2021

15 minutes ago, mrmicbkktxl said:

How to register a Thai person?If a Thai moves from one district to another in the same province does he/she needs to unregister from one hospital first or can go to the new hospital right away?What documents are required?

It can now be done oneline via an app, see here https://workpointtoday.com/health-23/

Many people don't bother to change their registration though. In some cases it is advantageous, in others not.

SomchaiCNX · June 12, 2021

23 minutes ago, mrmicbkktxl said:

How to register a Thai person?If a Thai moves from one district to another in the same province does he/she needs to unregister from one hospital first or can go to the new hospital right away?What documents are required?

Tabian Baan adjustment? Register at the new address.

doontp · June 12, 2021

21 minutes ago, Sheryl said:

Having the same blood type is a requirement but does not mean she is a match, would still have to do a tissue typing.

Donating a kidney has no effect on the ability to conceive, though it is recommended to wait 6 months after the procedure. There is a very small increase in the risk of pregnancy complications.

The main implication for the donor is that they are more vulnerable to the effects of kidney disease in the future since they have only one functioning kidney. And trauma to the remaining kidney (from an accident etc) would be life threatening.

Good overviews here. The fiorst oen addresses pregnancy

https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation

https://weillcornell.org/services/kidney-and-pancreas-transplantation/living-donor-kidney-center/about-the-program/risks-and-benefits-of-living-donation

If you are considering waiting for a cadaver kidney (donation from dead person) you should definitely stay in the US as the wait is longer in Thailand.

Would there be any issue in us moving to Thailand and then returning to the US when a kidney becomes available?

We would still maintain a legal domicile in the US as a result of home ownership and drivers license.

I just don't see how I can continue with my current job, as it is not considered sedentary. I would like to teach English and Math at a school in Thailand. That is what I did from 2008-15.

SomchaiCNX · June 12, 2021

14 hours ago, doontp said:

My wife and I have the same blood type, but she has not been tested. She's concerned that donating a kidney would lessen her chances of getting pregnant.

We have been discussing options and possibilities.

Was my question as well do they match, mostly, sister, brother, child, parent

NightSky · June 12, 2021

Although it seems fine at first glance, I wouldn’t trust the Thai government health system.

I don’t want to cause alarm but I would remain in the US to receive the transplant because I know someone who got a serious blood bourne disease from a Thai government hospital blood transfusion that was never admitted to or picked up/tested for and it was only picked up by a blood test that occurred and was treated later outside of Thailand.

This is known because a screening blood test was negative prior to the transfusion.

I wish you well with the transplant, you must have a lovely partner to want to donate. Although for what my opinion is worth to you, I would wait to see if an organ becomes available in the US as the safest option.

Edited June 12, 2021 by NightSky

Sheryl · June 12, 2021

3 hours ago, doontp said:

Would there be any issue in us moving to Thailand and then returning to the US when a kidney becomes available?

You'd need to ask your doctor in the US. The issues would be if you needed to be seen there periodically to remain on the transplant list.

Also - remember what the world has just been through with COVID in terms of travel restrictions and that the pandemic is far from over. Do you have US citizenship? If so then, though getting a flight could be problematic, I don't envision the US ever blocking its own citizens from returning home (might face quarantine on arrival though). But if not - you can't assume being able to get back in when you want to if the pandemic continues.

doontp · June 12, 2021

4 hours ago, Sheryl said:

You'd need to ask your doctor in the US. The issues would be if you needed to be seen there periodically to remain on the transplant list.

Also - remember what the world has just been through with COVID in terms of travel restrictions and that the pandemic is far from over. Do you have US citizenship? If so then, though getting a flight could be problematic, I don't envision the US ever blocking its own citizens from returning home (might face quarantine on arrival though). But if not - you can't assume being able to get back in when you want to if the pandemic continues.

My wife and I are dual citizens. My wife is 100% Thai and she gained US Citizenship through our marriage. I am half Thai half American. Was born in Thailand and raised in the US. My mom was Thai and dad American.

I will discuss the possibilities with doctor.

widarp · June 12, 2021

Hi there
Me and my wife has been through this a couple of years ago. Not living donor though

If you have a donor that fulfills all stringent criteria

,it is not just the blood group.

Fine you can choose any of the them

Chula , Srirajt or Ramathibodi

There will also be a lot of tests that the reciever needs to go through.

The most important factor is that it is a perfect match

If your donor doesnt match you 100%

I would do it privately and you can recieve a kidney from the Thai Red Cross.

Waiting time depends

For us less than a year

All depending on the best match and if the hospital is ready.

We used Rama 9 hospital as they have a lot of teams standby

The cost is under 1 million THB if no complications

If privately they will charge you a lot for all medication and tests needed afterwards.

You may be able to get that from the National Health Service but they seem to be a bit reluctant if you have done this privately

I would choose a hospital near where you live as you are going to spend a lot of time going there.
especially the first year

Good Luck

doontp · June 13, 2021

3 hours ago, widarp said:

Hi there
Me and my wife has been through this a couple of years ago. Not living donor though

If you have a donor that fulfills all stringent criteria

,it is not just the blood group.

Fine you can choose any of the them

Chula , Srirajt or Ramathibodi

There will also be a lot of tests that the reciever needs to go through.

The most important factor is that it is a perfect match

If your donor doesnt match you 100%

I would do it privately and you can recieve a kidney from the Thai Red Cross.

Waiting time depends

For us less than a year

All depending on the best match and if the hospital is ready.

We used Rama 9 hospital as they have a lot of teams standby

The cost is under 1 million THB if no complications

If privately they will charge you a lot for all medication and tests needed afterwards.

You may be able to get that from the National Health Service but they seem to be a bit reluctant if you have done this privately

I would choose a hospital near where you live as you are going to spend a lot of time going there.
especially the first year

Good Luck

Thank you for the info. It gives a little hope.

doontp · June 13, 2021

3 hours ago, widarp said:

Hi there
Me and my wife has been through this a couple of years ago. Not living donor though

If you have a donor that fulfills all stringent criteria

,it is not just the blood group.

Fine you can choose any of the them

Chula , Srirajt or Ramathibodi

There will also be a lot of tests that the reciever needs to go through.

The most important factor is that it is a perfect match

If your donor doesnt match you 100%

I would do it privately and you can recieve a kidney from the Thai Red Cross.

Waiting time depends

For us less than a year

All depending on the best match and if the hospital is ready.

We used Rama 9 hospital as they have a lot of teams standby

The cost is under 1 million THB if no complications

If privately they will charge you a lot for all medication and tests needed afterwards.

You may be able to get that from the National Health Service but they seem to be a bit reluctant if you have done this privately

I would choose a hospital near where you live as you are going to spend a lot of time going there.
especially the first year

Good Luck

Do they require the entire payment up front? Or do they offer payment plans?

ncc1701d · June 18, 2021

FWIW, my girlfriends sister in-law had to get an emergency kidney only a few months ago. A living donor who had cancer, had a perfectly good kidney that he wanted to sell before he died to help his family. One kidney cost B50,000. All organised through the doctors / hospital. She's recovering very well. Sorry, can't remember how much the actual surgery etc cost - but the kidney was the most expensive thing out of the whole ordeal.

doontp · June 18, 2021

46 minutes ago, ncc1701d said:

FWIW, my girlfriends sister in-law had to get an emergency kidney only a few months ago. A living donor who had cancer, had a perfectly good kidney that he wanted to sell before he died to help his family. One kidney cost B50,000. All organised through the doctors / hospital. She's recovering very well. Sorry, can't remember how much the actual surgery etc cost - but the kidney was the most expensive thing out of the whole ordeal.

That must have been done under the table. Not complaining, but organ selling is illegal. Whatever it takes. I have no complaints.

Was this in Thailand?

widarp · June 18, 2021

You cant buy kidneys in Thailand any more....
This buying story doesnt add up
Iran is the only place I know of where you legally can "buy" a kidney

Sheryl · June 18, 2021

On 6/13/2021 at 9:24 AM, doontp said:

Do they require the entire payment up front? Or do they offer payment plans?

A private hospital will nto do the procedure without clear proof of ability to pay first. They will typically demand a deposit of an amount equal to the estimated cost.

ncc1701d · June 18, 2021

I don't know how it was arranged, but I can guarantee that it was done and at an international hospital. As for the legality - I have no idea (yes, Thailand)

Either that - or it's the most elaborate new version on the "sick buffalo" story need for money that I've ever heard ????

Edited June 18, 2021 by ncc1701d

doontp · June 18, 2021

5 hours ago, ncc1701d said:

I don't know how it was arranged, but I can guarantee that it was done and at an international hospital. As for the legality - I have no idea (yes, Thailand)

Either that - or it's the most elaborate new version on the "sick buffalo" story need for money that I've ever heard ????

Crazier things happen everyday.

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