Less Pre-Kidney Transplant Dialysis With Preemptive Waitlist
Preemptively listed recipients have about four fewer years of pretransplant dialysis
(HealthDay News) -- Kidney transplant patients who are preemptively wait-listed have substantially fewer years of pretransplant dialysis than transplant recipients listed after dialysis onset, according to a study published online in Clinical Transplantation.
Meera N. Harhay, MD, from the Drexel University College of Medicine in Philadelphia, and colleagues retrospectively compared pretransplant dialysis durations among 65,385 adult US kidney transplant recipients of deceased donor organs between the period before implementation of the new kidney transplant allocation system (KAS; Dec. 4, 2011, to Dec. 3, 2014) and the post-KAS period (Dec. 4, 2014, to Dec. 3, 2017).
The researchers found that preemptively listed recipients (21%) were more likely to be white (59 vs 34%) and have private insurance (64 vs 30%). Average adjusted pretransplant dialysis durations for preemptively listed recipients were less than 2 years in all racial groups in the pre- and post-KAS periods. Preemptively listed recipients experienced 3.85 fewer average years of pretransplant dialysis in the pre-KAS period and 4.53 fewer average years of pretransplant dialysis in the post-KAS period compared with recipients who were listed after starting dialysis.
"Efforts are needed to improve both socioeconomic and racial disparities in preemptive wait-listing," the authors write.
Harhay M, Harhay M, Ranganna K, et al. Association of the kidney allocation system with dialysis exposure before deceased donor kidney transplantation by preemptive wait‐listing status. Clin Trans. DOI:10.1111/ctr.13386. (Published online August 21, 2018)