Hospitalization and Living Donor Kidney Transplantation Among Waitlisted End Stage Renal Disease Patients in the US.
1Emory University Rollins School of Public Health, Atlanta, GA
2Emory University School of Medicine, Atlanta, GA.
Meeting: 2016 American Transplant Congress
Abstract number: A138
Keywords: African-American, Hispanic, Kidney transplantation, Waiting lists
Session Information
Date: Saturday, June 11, 2016
Session Name: Poster Session A: Kidney Donor Outcomes
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background: For End Stage Renal Disease Patients (ESRD) waitlisted for a deceased donor kidney, living donor kidney transplantation (LDKT) could allow for earlier transplantation and better outcomes. Hospitalization may be a proxy for disease severity, and could motivate individuals to identify or convince potential living donors, however, the association between hospitalization among waitlisted patients and receipt of LDKT has not been investigated.
Methods: We examined 24,581 waitlisted ESRD patients with continuous enrollment in Medicare Parts A & B between 2005 and 2009 and followed through 2009 in the United States Renal Data System (USRDS) Medicare-linked data to examine the association between annual hospitalization rate and odds of receiving a LDKT. We used multi-level random effects models to estimate odds ratios (OR), controlling for individual-, transplant center-, and organ procurement organization-level clustering and survival analysis.
Results: A total of 2,896 (11.8%) waitlisted individuals received a LDK during the study period. Compared to individuals who were not hospitalized, patients hospitalized >0-<2 times per year (n=7,441) were less likely to receive a LDKT (Figure 1; >0-<2 vs. 0 hospitalizations/year OR=0.46; p<0.001).
However, individuals who were hospitalized >2 times per year (n=4,345) had no significant difference in their likelihood of receiving a LDKT compared to individuals who had never been hospitalized (Figure 1; 2+ vs. 0 hospitalizations/year OR=0.86; p=0.195). Though Hispanic and black individuals were significantly less likely than non-hispanic whites to receive a LDKT (both p<0.0001), the observed association between hospitalization rate and LDKT did not vary significantly by race/ethnicity (p=0.191)
Conclusion: Individuals who were hospitalized more frequently while waitlisted were more likely to receive a LDKT than individuals who were hospitalized less frequently. This association persisted, regardless of race/ethnicity.
CITATION INFORMATION: Newman K, Adams A, Pastan S, Lynch R, Zhang R, Patzer R. Hospitalization and Living Donor Kidney Transplantation Among Waitlisted End Stage Renal Disease Patients in the US. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Newman K, Adams A, Pastan S, Lynch R, Zhang R, Patzer R. Hospitalization and Living Donor Kidney Transplantation Among Waitlisted End Stage Renal Disease Patients in the US. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/hospitalization-and-living-donor-kidney-transplantation-among-waitlisted-end-stage-renal-disease-patients-in-the-us/. Accessed May 27, 2020.« Back to 2016 American Transplant Congress