Barriers to Becoming Active on the Renal Transplant Waiting List: Have They Changed in the Last Five Years?

E. van Hardeveld,¹ T. Furlong,² A. Robertson,² N. Suh,² S. Thwaites,² R. Millar,² R. Masterson,¹ M. Lian,¹ B. Jones,¹ P. Hughes.¹

¹Department of Nephrology, Royal Melbourne Hospital, Melbourne, Australia
²Nephrology Surgery, Royal Melbourne Hospital, Melbourne, Australia

Meeting: 2017 American Transplant Congress

Abstract number: C45

Keywords: Obesity, Waiting lists

Session Information

Session Name: Poster Session C: Disparity in Access and Outcomes for Solid Organ Transplantation

Session Type: Poster Session

Date: Monday, May 1, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

PURPOSE

We have previously studied the barriers preventing patients from being made active on the transplant waiting list (TWL) and implemented practice changes to improve the rate of listing. We have now reviewed the rates of patient listing again after 3 years to determine our success in modifying these barriers and whether the barriers have changed.

BACKGROUND

In Australia in 2012 only 19% of dialysis patients under the age of 65 were active on the TWL. This led us to examine the barriers to patients being listed on the kidney TWL at our major metropolitan and regional service. Of patients commencing renal replacement therapy between January 2010 and December 2011 the top 3 reasons for not being ACTIVE were obesity (26%), extensive cardiovascular disease (20%) and failure to be referred for transplant assessment (19%). Focus on potentially modifiable barriers obesity and lack of referral was made a priority.

RESULTS

Data on patients commencing dialysis between January 2013 and December 2014 were analysed. The most common reason for not achieving ACTIVE status in the more recent cohort was failure to be referred (37%) followed by cardiac (22%) and social/cultural reasons (11%). Obesity was barrier in only 9%. Further analysis of this cohort showed that there was no difference in BMI of patients in the two time periods but rather a change in surgical acceptance. There was also an increase in the cultural diversity of the dialysis population, including an increase in the number of patients from a non-English speaking background, those with poor literacy and refugee status, resulting in additional challenges to an already complex process.

CONCLUSION

Obesity is a barrier to transplantation in far fewer patients following a change in surgical acceptance and practice. However, mechanisms of referral continue to be a major issue in the timely assessment of patients for kidney transplant and activation on TWL. Strategies for educating and assessing different cultural groups will need to be a priority for future practice.

CITATION INFORMATION: van Hardeveld E, Furlong T, Robertson A, Suh N, Thwaites S, Millar R, Masterson R, Lian M, Jones B, Hughes P. Barriers to Becoming Active on the Renal Transplant Waiting List: Have They Changed in the Last Five Years? Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Hardeveld Evan, Furlong T, Robertson A, Suh N, Thwaites S, Millar R, Masterson R, Lian M, Jones B, Hughes P. Barriers to Becoming Active on the Renal Transplant Waiting List: Have They Changed in the Last Five Years? [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/barriers-to-becoming-active-on-the-renal-transplant-waiting-list-have-they-changed-in-the-last-five-years/. Accessed November 25, 2024.

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