2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2005050517v1 16/10/3121    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schold, J. D. Articles by Meier-Kriesche, H.-U. Search for Related Content PubMed PubMed Citation Articles by Schold, J. D. Articles by Meier-Kriesche, H.-U.

Access to Quality: Evaluation of the Allocation of Deceased Donor Kidneys for Transplantation

Jesse D. Schold^*,, Bruce Kaplan^*, Neale R. Chumbler^,,||, Richard J. Howard, Titte R. Srinivas^*, Linan Ma^* and Herwig-Ulf Meier-Kriesche^*

^* Departments of Medicine, Surgery, Health Services Research, Management and Policy, University of Florida, Gainesville; Florida Rehabilitation Outcomes Research Center and ^|| Stroke Quality Enhancement Research Initiative, Veterans Affairs Health Services Research and Development/Rehabilitation Outcomes Research Center, Center of Excellence, North Florida/South Georgia Veterans Health System, Gainesville, Florida

Address correspondence to: Mr. Jesse Dylan Schold, Research Programs and Services, Division of Nephrology, Hypertension and Transplantation, University of Florida College of Medicine, PO Box 100224, Gainesville, Florida 32610-0224. Phone: 352-846-2692; Fax: 352-392-5465; E-mail: scholjd{at}medicine.ufl.edu

Received for publication May 17, 2005. Accepted for publication July 19, 2005.

Disparities in both access to the kidney transplant waiting list and waiting times for transplant candidates have been extensively documented with regard to ethnicity, gender, socioeconomic factors, and region. However, the issue of access to equivalent quality organs has garnered less attention. The principal aim of this study was to determine whether certain patient populations were more likely to receive lower quality organs. This was a retrospective cohort study of all deceased-donor adult renal transplant recipients in the United States from 1996 to 2002 (n = 45,832). Using previously reported categorization of donor quality (I to V), the propensity of transplant recipients to receive lower-quality kidneys in a cumulative logit model was evaluated. Older patients were progressively more likely to receive lower-quality organs (age 65 yr, odds ratio [OR] = 2.1, P < 0.01) relative to recipients aged 18 to 24 yr. African American and Asian recipients had a greater likelihood of receiving lower-quality organs relative to non-Hispanic Caucasians. Regional allocation networks were highly variable with regard to donor quality. Neither recipient gender (OR = 1.00, P = 0.81) nor patient’s primary diagnosis were associated with donor quality. Findings suggest that disparities in the quality of deceased donor kidneys to transplant recipients exist among certain patient groups that have previously documented access barriers. The extent to which these disparities are in line with broad policies of equity and potentially modifiable will have to be examined in the context of allocation policy.

This article has been cited by other articles:

				E. J. Gordon and J. C. Caicedo Ethnic advantages in kidney transplant outcomes: the Hispanic Paradox at work? Nephrol. Dial. Transplant., December 15, 2008; (2008) gfn691v1. [Full Text] [PDF]

				S. Ramirez Race and Kidney Disease Outcomes: Genes or Environment? J. Am. Soc. Nephrol., December 1, 2005; 16(12): 3461 - 3463. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673