Factors Related to International Travel for Transplantation among US-Listed Kidney Transplant Candidates

B. Koons¹, M. L. Henderson², A. G. Thomas³, T. Kear⁴, H. Moriarty⁴

¹School of Nursing, University of Pennsylvania, Philadelphia, PA, ²Department of Surgery in the Division of Transplantation, Johns Hopkins University, Baltimore, MD, ³Department of Epidemiology, University of North Carolina, Chapel Hill, NC, ⁴M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA

Meeting: 2019 American Transplant Congress

Abstract number: 215

Keywords: Ethics, Kidney transplantation, Risk factors, Waiting lists

Session Information

Session Name: Concurrent Session: Kidney Deceased Donor Allocation II

Session Type: Concurrent Session

Date: Monday, June 3, 2019

Session Time: 2:30pm-4:00pm

Presentation Time: 3:18pm-3:30pm

Location: Ballroom B

*Purpose: The aim of this study was to identify factors associated with international travel for transplantation among US-listed kidney transplant (KT) candidates.

*Methods: Using 2010-2016 data from the Scientific Registry for Transplant Recipients and the Country Health Rankings, we identified 364 adult KT candidates who received a KT abroad and 76,133 candidates who received a deceased donor kidney transplant (DDKT) in the US. Differences in characteristics between candidates who received a DDKT in the US and those who traveled abroad for KT were assessed using the χ² and Mann-Whitney rank-sum tests. We assessed factors associated with travel for transplantation using adjusted logistic regression.

*Results: Of the 364 adult candidates who traveled outside the US for KT during the study time period, 354 candidates provided data on the country where they underwent transplantation. Candidates listed a total of 46 different countries (see Figure 1). The countries with the higher number of KT of U.S.-listed candidates were the Philippines (n=93), India (n=52), China (n=30), Mexico (n=30), Iran (n=18), Pakistan (n=17), Canada (n=12), and Egypt (n=12). Candidates who traveled abroad for KT had greater odds of being male (aOR: _1.151.46_1.86), Asian (aOR: _8.8111.58_15.21), Hispanic (aOR: _1.271.85_2.70), college educated (aOR: _1.622.14_2.81), employed (aOR: _1.131.46_1.88), privately insured (aOR: _1.241.61_2.09), and a non-U.S. citizen/non-U.S. resident (aOR: _7.4711.40_17.38). Clinically, candidates with a BMI greater than 30 (aOR: _0.450.61_0.81), a cPRA greater than 95 (aOR: _0.160.31_0.62), and who had a history of dialysis use of 2 to 6 years (aOR: _0.310.42_0.56) or longer than 6 years (aOR: _0.070.12_0.20) had lower odds of traveling abroad a KT. Compared to candidates listed in region 5, candidates listed in region 9 had higher odds of traveling abroad for KT (aOR: _1.582.22_3.10) and candidates listed in regions 6,8, and 11 all had lower odds of traveling abroad for KT.

*Conclusions: These findings provide the most comprehensive understanding of factors related to travel for transplantation among U.S. KT candidates to date.

Figure 1. Countries where US-listed candidates underwent KT outside of the US. Darker colors indicate higher number of KTs performed.

To cite this abstract in AMA style:

Koons B, Henderson ML, Thomas AG, Kear T, Moriarty H. Factors Related to International Travel for Transplantation among US-Listed Kidney Transplant Candidates [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-related-to-international-travel-for-transplantation-among-us-listed-kidney-transplant-candidates/. Accessed May 9, 2025.

« Back to 2019 American Transplant Congress