Inequalities in Kidney Transplant Lists
(Ivanhoe Newswire) -- New research shows major inequalities still exist in Scotland's kidney transplant waiting list. Researchers say these inequalities may also exist elsewhere in the United Kingdom.
Researchers followed more than 4,500 adults from the time they started kidney replacement therapy until they were placed on a kidney transplant waiting list, had a transplant, died or until the end of the study. Researchers say 38 percent of patients were placed on the waiting list for a kidney transplant and 24 percent underwent a transplant during the study.
In Scotland, kidney transplantation is the most successful and cost-effective treatment for end stage kidney failure, but not all patients on dialysis are suitable for transplantation and there is evidence that selection criteria vary widely. Researchers say evidence from the United States shows that transplantation rates are associated with a patient's health status as well as socioeconomic and geographical factors. They note the rates vary significantly with age and race and between men and women. In this study, researchers investigated the relationship between socioeconomic and geographical factors and access to the kidney transplant waiting list in Scotland.
Results show patients were less likely to be placed on a waiting list if they were female, older, had diabetes, were socially deprived, or were treated in a hospital with no transplant unit. Researchers write, "Patients had a better chance of being placed on the waiting list when they started dialysis in a renal unit in a hospital with a transplant unit." They also found patients who lived the furthest from the transplant center were listed more quickly.
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SOURCE: British Medical Journal, 2003;327:1261-1263
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