OBJECTIVE: The objective of this project was to analyse the 1-year direct medical costs of kidney transplantation performed in Belgium. METHODS: Data from the last 150 patients who received a kidney transplantation at UCL Cliniques Universitaires St Luc (Belgium) and for which a follow-up of 1-year was available were analysed. All patients were adults at the age of the transplantation and treated with cyclosporine. Patients files were retrospectively analysed. Key parameters, such as: primary hospitalisation for transplantation; immunosuppressive drug use; patient survival; graft survival; acute rejection; CMV infection; other adverse events and serious complications; treatment of adverse events; treatment of complications; repeat hospitalization; and follow-up hospital consultations were recorded. Total length of stay in the hospital was also recorded. For each patient, information up to 1-year post renal transplantation (or until death if death occurred within 1-year of transplantation) was collected. Costing information was obtained from anonymous hospital bills which provided amounts paid by the health care payer and patient. Three perspectives were considered in this study, i.e. the health care payer (INAMI/RIZIV), the patient, and the societal perspectives. RESULTS: For the whole population (n=150), the mean direct medical costs from the societal perspective, health care payer’s perspective, and patient’s perspective amounted to 40,574€, 38,566€ (of which 28,844€ for hospitalisation only), and 2,008€, respectively. During this one year period, patients were hospitalised for 29 days on average. CONCLUSIONS: One year direct medical costs of kidney transplantation are substantial. In Belgium, most of the direct medical costs are borne by the health care payer, and the main cost driver are hospital costs.