Journal article
Listing at non-local transplant centers is associated with increased access to deceased donor kidney transplantation
American journal of transplantation, Vol.22(7), pp.1813-1822
07/01/2022
DOI: 10.1111/ajt.17044
PMCID: PMC9580509
PMID: 35338697
Abstract
The ability of kidney transplant candidates to travel outside of their usual place of care varies by sociodemographic factors, potentially exacerbating disparities in access. We used Transplant Referral Regions (TRRs) to overcome previous methodological barriers of using geographic distance to assess the characteristics and outcomes of patients listed for kidney transplant at centers in neighboring TRR or beyond neighboring TRRs. Among listed kidney transplant candidates, 20.9% traveled to a neighbor and 5.6% beyond a neighbor. A higher proportion of travelers were White, had some college education, and lived in ZIP codes with lower poverty. Travel to a neighbor was associated with a 7% increase in likelihood of deceased donor transplant (cHR: 1.07, 95% CI: 1.05, 1.09) and traveling beyond a neighbor with a 19% increase (cHR: 1.19, 95% CI: 1.15, 1.24). Travelers had similar rates of living donor transplant and waitlist mortality as patients who did not travel; those who traveled beyond a neighbor had slightly lower posttransplant mortality (HR: 0.91, 95% CI: 0.83, 0.99). In conclusion, the ability to travel outside of the recipient's assigned TRR increases access to transplantation and improves long-term survival.
Details
- Title: Subtitle
- Listing at non-local transplant centers is associated with increased access to deceased donor kidney transplantation
- Creators
- Katherine Ross-Driscoll - Emory UniversityJonathan Gunasti - Emory UniversityRaymond J. Lynch - Emory UniversityAllan Massie - Johns Hopkins UniversityDorry L. Segev - Johns Hopkins UniversityJon Snyder - University of MinnesotaDavid Axelrod - University of IowaRachel E. Patzer - Emory University
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.22(7), pp.1813-1822
- DOI
- 10.1111/ajt.17044
- PMID
- 35338697
- PMCID
- PMC9580509
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- UL1TR002378; KL2TR002381 / National Center for Advancing Translational Sciences of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 07/01/2022
- Academic Unit
- Surgery
- Record Identifier
- 9984322956902771
Metrics
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