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New research shows that efforts to improve kidney transplant access have not been effective in recent years. The results will appear in an upcoming issue of JASN.
A kidney transplant is the best treatment option for patients with kidney failure because it significantly improves their quality of life and extends their survival. Unfortunately, patients can face significant barriers in being assessed for a transplant and placed on a transplant waiting list. In recent years, studies have identified such barriers and pointed to differences in certain patient groups. In addition, numerous strategies, research studies and interventions have been developed to address these deficiencies and improve access to transplantation.
To investigate the impact of such efforts, Jesse Schold, Ph.D., MStat, MEd (Cleveland Clinic) and colleagues analyzed information on 1,309,998 adults with kidney failure listed in the United States Renal Data System from 1997 to 2016. The researchers found no overall improvement in waiting list placement and transplant rates over the two decades, and they found consistently low rates among vulnerable populations, such as lower-income communities.
“These results suggest that the cumulative efforts to improve access to transplantation have had minimal impact on the general population and more effective strategies are needed,” said Dr. Schold. “Furthermore, the differences in access to the transplant are striking, suggesting that many factors beyond the clinical risks and the viability of the procedure affect the ability of patients to receive a transplant.”
Dr. Schold stressed that more effective and proactive strategies are needed to improve access to transplantation. “This may include the systematic recording of patients referred for transplant and evaluated, the automated referral of patients for transplant based on eligibility criteria and incentive guidelines, such as those initiated by the Executive Order to Promote American Kidney Health.”
The study examines social determinants of disparities in kidney transplantation
“In the United States, access to kidney transplantation has not improved in two decades,” JASN DOI: 10.1681 / ASN.2020060888, provided by the American Society of Nephrology
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